inotuzumab ozogamicin at a glance
Medicine class
CD22-directed antibody–drug conjugate and antineoplastic treatment.
Licensed use
Relapsed or refractory CD22-positive B-cell precursor acute lymphoblastic leukaemia in adults.
Administration
Given by intravenous infusion by a specialist cancer team; it is not taken at home.
Key safety issue
Can cause serious liver injury, including sinusoidal obstruction syndrome, particularly around a subsequent stem-cell transplant.
Routine checks
Blood counts, liver function and signs of infection or bleeding are monitored closely.
What is inotuzumab ozogamicin used for?
UK-licensed use:
Monotherapy for adults with relapsed or refractory CD22-positive B-cell precursor acute lymphoblastic leukaemia.
For Philadelphia-chromosome-positive disease, at least one tyrosine kinase inhibitor must previously have failed.
How does inotuzumab ozogamicin work?
The antibody recognises CD22 on B-cell leukaemia cells and enters the cell. It then releases a calicheamicin derivative that damages DNA, leading to cell death.
inotuzumab ozogamicin preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 1 mg
How to take inotuzumab ozogamicin
Trained healthcare professionals prepare inotuzumab ozogamicin and give it into a vein. Premedicines are normally given to reduce infusion reactions. Some people also receive hydration and treatment to reduce tumour lysis risk. Patients are observed during and after administration.
It must not be given as an intravenous push or bolus.
The powder requires reconstitution and dilution before use.
Tell staff immediately about fever, chills, breathing difficulty, dizziness or other new symptoms during the infusion.
inotuzumab ozogamicin side effects
Common or expected effects
- Low platelets, neutrophils, red cells or other blood cells
- Infections and fever
- Tiredness
- Bleeding or easy bruising
- Nausea, vomiting, diarrhoea or constipation
- Abdominal pain or mouth inflammation
- Headache or reduced appetite
- Abnormal liver blood tests or raised bilirubin
- Chills or an infusion-related reaction
Get urgent medical advice
- Serious infection or febrile neutropenia
- Severe bleeding
- Liver injury, including veno-occlusive disease or sinusoidal obstruction syndrome
- Severe infusion or hypersensitivity reaction
- Tumour lysis syndrome
- Abnormal heart rhythm associated with QT prolongation
- Severe or prolonged reduction in blood cells
inotuzumab ozogamicin in pregnancy
Inotuzumab ozogamicin may harm an unborn baby and is generally avoided during pregnancy unless a specialist judges that maternal benefit outweighs fetal risk. Effective contraception is required during treatment and afterwards—at least 8 months for women and at least 5 months for men with partners who could become pregnant. Contact the treatment team immediately if pregnancy occurs, and discuss fertility preservation before treatment.
inotuzumab ozogamicin while breastfeeding
Do not breastfeed during treatment or for at least 2 months after the final administration because serious effects in a breastfed child cannot be excluded. Discuss feeding options with the specialist team.
inotuzumab ozogamicin interactions
Tell the specialist team about all prescribed, non-prescribed and herbal products. Formal interaction studies are limited.
Medicines that prolong the QT interval or can cause torsades de pointes
Combining them may increase abnormal-heart-rhythm risk; careful assessment and ECG monitoring may be needed.
Live viral vaccines
These are not recommended shortly before treatment, during treatment or until B lymphocytes have recovered.
Common questions about inotuzumab ozogamicin
Answers are fully visible for fast scanning and source review.
What is inotuzumab ozogamicin used to treat?
It is licensed for adults with relapsed or refractory CD22-positive B-cell precursor acute lymphoblastic leukaemia.
Is inotuzumab ozogamicin chemotherapy or an antibody?
It is an antibody–drug conjugate: an antibody targets CD22 and carries a cytotoxic substance into the leukaemia cell.
How is inotuzumab ozogamicin given?
A specialist healthcare team prepares it and gives it through an intravenous infusion, with observation for reactions.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.