Select a medication above to begin.
Blincyto
blinatumomab
Black Box Warnings .
Cytokine Release Syndrome
life-threatening or fatal events have occurred; monitor signs/symptoms; advise outpatients to seek immediate medical attention if CRS signs/symptoms occur; interrupt tx, administer corticosteroids, and/or permanently D/C based on severity
Neurological Toxicities
including immune effector cell-associated neurotoxicity syndrome (ICANS) and severe, life-threatening, or fatal events occurred in 65% of patients; may occur concurrently with CRS, after CRS resolution, or in the absence of CRS; monitor signs/symptoms; advise outpatients to seek immediate medical attention if neurological toxicities signs/symptoms occur; interrupt tx, administer corticosteroids, and/or permanently D/C based on severity
Adult Dosing .
Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, intrathecal chemo prophylaxis, and dosing including toxicity-related dose adjustments
CD19-positive minimal residual disease (MRD)-positive B-cell precursor ALL
- [induction tx, <45 kg]
- Dose: 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle; Max: 28 mcg/day; Info: for patients in 1st or 2nd complete remission with MRD 0.1% or greater
- [induction tx, >45 kg]
- Dose: 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle; Info: for patients in 1st or 2nd complete remission with MRD 0.1% or greater
- [consolidation tx, <45 kg]
- Dose: 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle for up to 3 cycles; Max: 28 mcg/day; Info: for patients in 1st or 2nd complete remission with MRD 0.1% or greater
- [consolidation tx, >45 kg]
- Dose: 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle for up to 3 cycles; Info: for patients in 1st or 2nd complete remission with MRD 0.1% or greater
CD19-positive B-cell precursor ALL, relapsed or refractory
- [induction tx, <45 kg]
- Dose: 5 mcg/m^2/day IV continuous infusion qd on days 1-7 of 42-day cycle, then 15 mcg/m^2/day IV continuous infusion qd on days 8-28 of 42-day cycle; Max: 9 mcg/day on days 1-7, 28 mcg/day on days 8-28; Info: may give x1 additional cycle 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle, max 28 mcg/day
- [induction tx, >45 kg]
- Dose: 9 mcg/day IV continuous infusion qd on days 1-7 of 42-day cycle, then 28 mcg/day IV continuous infusion qd on days 8-28 of 42-day cycle; Info: may give x1 additional cycle 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle
- [consolidation tx, <45 kg]
- Dose: 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle x3 cycles; Max: 28 mcg/day; Info: may give continued tx 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 84-day cycle for up to 4 cycles, max 28 mcg/day
- [consolidation tx, >45 kg]
- Dose: 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle x3 cycles; Info: may give continued tx 28 mcg/day IV continuous infusion qd on days 1-28 of 84-day cycle for up to 4 cycles
CD19-positive Ph-negative B-cell precursor ALL, consolidation tx
- [<45 kg]
- Dose: 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle; Max: 28 mcg/day; Info: give up to 4 cycles with alternating cycles of chemo; may proceed to HSCT after 1-2 cycles
- [>45 kg]
- Dose: 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle; Info: give up to 4 cycles with alternating cycles of chemo; may proceed to HSCT after 1-2 cycles
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin 1.1-3x ULN or AST >ULN: no adjustment; bilirubin >3x ULN: not defined
Peds Dosing .
- Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, intrathecal chemo prophylaxis, and dosing including toxicity-related dose adjustments
CD19-positive minimal residual disease (MRD)-positive B-cell precursor ALL
- [induction tx, 1 mo and older, <45 kg]
- Dose: 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle; Max: 28 mcg/day; Info: for patients in 1st or 2nd complete remission with MRD 0.1% or greater
- [induction tx, 1 mo and older, >45 kg]
- Dose: 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle; Info: for patients in 1st or 2nd complete remission with MRD 0.1% or greater
- [consolidation tx, 1 mo and older, <45 kg]
- Dose: 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle for up to 3 cycles; Max: 28 mcg/day; Info: for patients in 1st or 2nd complete remission with MRD 0.1% or greater
- [consolidation tx, 1 mo and older, >45 kg]
- Dose: 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle for up to 3 cycles; Info: for patients in 1st or 2nd complete remission with MRD 0.1% or greater
CD19-positive B-cell precursor ALL, relapsed or refractory
- [induction tx, 1 mo and older, <45 kg]
- Dose: 5 mcg/m^2/day IV continuous infusion qd on days 1-7 of 42-day cycle, then 15 mcg/m^2/day IV continuous infusion qd on days 8-28 of 42-day cycle; Max: 9 mcg/day on days 1-7, 28 mcg/day on days 8-28; Info: may give x1 additional cycle 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle, max 28 mcg/day
- [induction tx, 1 mo and older, >45 kg]
- Dose: 9 mcg/day IV continuous infusion qd on days 1-7 of 42-day cycle, then 28 mcg/day IV continuous infusion qd on days 8-28 of 42-day cycle; Info: may give x1 additional cycle 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle
- [consolidation tx, 1 mo and older, <45 kg]
- Dose: 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle x3 cycles; Max: 28 mcg/day; Info: may give continued tx 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 84-day cycle for up to 4 cycles, max 28 mcg/day
- [consolidation tx, 1 mo and older, >45 kg]
- Dose: 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle x3 cycles; Info: may give continued tx 28 mcg/day IV continuous infusion qd on days 1-28 of 84-day cycle for up to 4 cycles
CD19-positive Ph-negative B-cell precursor ALL, consolidation tx
- [1 mo and older, <45 kg]
- Dose: 15 mcg/m^2/day IV continuous infusion qd on days 1-28 of 42-day cycle; Max: 28 mcg/day; Info: give up to 4 cycles with alternating cycles of chemo; may proceed to HSCT after 1-2 cycles
- [1 mo and older, >45 kg]
- Dose: 28 mcg/day IV continuous infusion qd on days 1-28 of 42-day cycle; Info: give up to 4 cycles with alternating cycles of chemo; may proceed to HSCT after 1-2 cycles
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin 1.1-3x ULN or AST >ULN: no adjustment; bilirubin >3x ULN: not defined