Abecma (idecabtagene vicleucel) is prescribed to treat multiple myeloma in certain cases. The drug comes as a suspension (liquid mixture) made from your body’s cells. You receive it by intravenous (IV) infusion into a vein.

Abecma is used in adults to treat multiple myeloma that either:

  • has returned after it was treated successfully before, or
  • has not improved with prior treatment (or it has stopped working)

For your doctor to prescribe Abecma, you must have been treated with two or more medications for multiple myeloma.

To learn more about Abecma’s uses, see the “What is Abecma used for?” section.

Abecma basics

Abecma contains the active ingredient idecabtagene vicleucel. It’s made from your own white blood cells. The drug belongs to a group of drugs called CAR T-cell therapies, which are a type of immunotherapy.

Abecma is a biologic medication. A biologic is made from parts of living organisms. It’s available only as a brand-name drug. It isn’t available in a biosimilar form.

Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.

Abecma has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should be considered before receiving Abecma?” section.

Abecma is used to treat multiple myeloma in adults in certain situations. Specifically, it’s used to treat multiple myeloma that either:

  • has returned after it was treated successfully before, or
  • has not improved with prior treatment (or it has stopped working)

If you’ve received at least two treatments for multiple myeloma before, your doctor may choose to prescribe Abecma. These two prior treatments could include:

Multiple myeloma is a type of blood cancer. It starts in the plasma cells of your bone marrow, where cancer cells multiply rapidly. You may experience few symptoms in early stages of multiple myeloma. But as it progresses, you may experience anemia or problems with your kidneys or bones.

Abecma is made from the T cells in your own blood that are modified in a lab. (T cells are a type of white blood cell.) These modified T cells bind to the B-cell maturation antigen (BCMA) receptor on cancer cells. BCMA aids cancer cells in growing and multiplying. But when Abecma binds to BCMA, it destroys cancer cells. Along with this action, it stimulates your body to make more T cells for protection.

While Abecma is given as a single infusion, you’ll receive other medications as part of your treatment plan. These medications include the following:

  • Chemotherapy drugs: You’ll receive cyclophosphamide and fludarabine for 3 days before you receive Abecma. (Your infusion may occur 2 to 7 days after chemotherapy is complete.)
  • Acetaminophen (Tylenol) and diphenhydramine: You’ll receive acetaminophen and diphenhydramine 30 to 60 minutes before your Abecma infusion starts. These drugs help reduce the risk of side effects.

Find answers to some commonly asked questions about Abecma.

How does Abecma compare with Carvykti?

Both Abecma and Carvykti (ciltacabtagene autoleucel) are used to treat multiple myeloma that either:

  • has returned after previous successful treatment, or
  • has not improved with prior treatment (or it has stopped working)

A doctor may prescribe Abecma after you’ve completed at least two other treatments for multiple myeloma. On the other hand, a doctor may prescribe Carvykti after you’ve completed one other treatment.

Both drugs come as a suspension (a type of liquid mixture) that you receive as an intravenous (IV) infusion. (This is an injection into your vein over a period of time.) Abecma and Carvykti are infusions that you receive only one time.

Abecma and Carvykti are CAR T-cell therapies. Both drugs are made from your own blood cells, but they contain different active ingredients. Abecma contains idecabtagene vicleucel, while Carvykti contains ciltacabtagene autoleucel.

If you have other questions about how Abecma and Carvykti compare, talk with your doctor. They can help you find the best treatment for your condition.

Can Abecma be used for other types of blood cancer?

Abecma is approved to treat only multiple myeloma that either:

  • has returned after it was treated successfully before, or
  • has not improved with prior treatment (or it has stopped working)

Your doctor may prescribe Abecma after you’ve completed at least two other treatments. It’s not approved to treat other types of blood cancer.

But Abecma’s prescribing information includes a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous. The warning concerns the risk of developing certain other types of cancer involving T cells. These are a type of white blood cell. If you receive Abecma, your doctor will monitor you for these types of cancer long after your infusion.

To learn more about treatment options for other types of blood cancers, talk with your doctor.

Whether or not you have health insurance, cost may be a factor when you’re considering Abecma. What you’ll pay for Abecma may depend on several things. These include your treatment plan and where you’ll receive your infusion.

Here are a few things to consider regarding Abecma’s price:

  • Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for certain medications when using coupons from the site. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
  • Savings program: If you have questions about how to pay for your prescription, talk with your doctor. A program called Cell Therapy 360 also may be available.

You can also check out this article to learn more about saving money on prescriptions.

Like most drugs, Abecma may cause mild to serious side effects. The lists below contain some of the more common side effects Abecma may cause. But the lists don’t include all side effects possible.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor can tell you more about the potential side effects of Abecma. They also can suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Abecma can cause. To learn about other mild side effects, talk with your doctor or read Abecma’s prescribing information.

Mild side effects of Abecma that have been reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor.

Serious side effects

Serious side effects from Abecma can occur. If you have serious side effects from Abecma, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Serious side effects of Abecma that have been reported include:

  • hypogammaglobulinemia (a condition in which your body makes lower amounts of antibodies and can’t effectively fight infection)
  • difficulty breathing or low oxygen levels
  • lower amounts of phosphate or sodium in your blood
  • higher amounts of certain liver enzymes or triglycerides in your blood
  • problems with how your blood clots
  • certain kidney problems
  • certain changes in your mental state, such as confusion or difficulty speaking
  • certain heart problems, such as a heart rate faster than normal or changes in blood pressure
  • various infections caused by viruses or bacteria (such as pneumonia)
  • changes in how safely you can drive or operate hazardous machinery
  • boxed warnings:
    • risk of developing cytokine release syndrome and neurologic toxicity
    • risk of developing certain dangerous immune system conditions
    • risk of having certain blood cell counts that are lower than normal for longer than usual
    • risk of developing certain other cancers

For more information about the boxed warnings, see the “What should be considered before receiving Abecma?” section.

Allergic reaction

The drug’s studies report that Abecma can cause an allergic reaction in some people.

In general, symptoms of allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

Your doctor can confirm whether you’ve had a serious allergic reaction to Abecma. If so, they may decrease your dose and monitor you more closely.

Your doctor will discuss the dosage of Abecma that you’ll receive. They’ll also describe the process of collecting your blood cells to make your dose.

Form and strength

Abecma is made from your own T cells, which are a type of white blood cell. Your white blood cells will be collected in a special facility and then sent to a lab. There, your T cells will be modified to help your body fight cancer better. This is known as a type of CAR T-cell therapy. The process usually takes about 4 weeks, but it could be longer depending on factors specific to your situation.

Abecma is a suspension (type of liquid mixture). You’ll receive it as a single intravenous (IV) infusion (an injection into your vein over a period of time). One infusion is a complete treatment course.

Recommended dosage

The usual dosage of Abecma for multiple myeloma is a single dose given as an IV infusion. (This is an injection into your vein over a period of time.) Your doctor will give you the medication, which you’ll receive over 30 minutes or longer.

To learn more about Abecma’s dosage, ask your doctor or visit the drugmaker’s website.

How to receive

Your doctor will explain how you’ll receive Abecma and how much. You’ll receive only one infusion.

You’ll receive other medications as part of your treatment plan, which is as follows:

  • Before Abecma: You’ll receive the chemotherapy drugs cyclophosphamide and fludarabine for 3 days.
  • Abecma infusion:
    • This usually occurs 2 days after your chemotherapy regimen is complete, but your doctor may delay it for up to 7 days. The delay may occur if you’ve had certain serious side effects, have an active infection, or have other concerns.
    • About 30 to 60 minutes before your Abecma infusion starts, you’ll receive acetaminophen (Tylenol) and diphenhydramine. These drugs help lower the risk of side effects.
    • You’ll receive Abecma as an intravenous (IV) infusion (an injection into your vein over a period of time) over at least 30 minutes. You may need more than one bag of medication to complete your infusion.

Following the infusion, you’ll remain in the facility where you received Abecma for at least 7 days. This is so that you can be monitored for side effects. After that time, you’ll need further monitoring. So you’ll want to stay close to the facility where you received Abecma for another 4 weeks.

To learn more about the Abecma infusion process, visit the drugmaker’s website.

Questions about receiving Abecma

Below are some common questions about receiving Abecma.

  • What if I miss a dose of Abecma? A complete course of Abecma is a single infusion. If you think you’ll miss your infusion appointment, call your doctor’s office right away. They’ll reschedule your infusion and provide further direction.
  • Will I need to receive Abecma long term? No, you won’t, because you’ll receive Abecma only once.
  • How long does Abecma take to work? Abecma begins to work right after you receive your infusion. Your doctor will order tests after your infusion to check whether Abecma is working for your condition. In studies, lab results in certain people showed their cancer was improving 1 month after receiving Abecma. Talk with your doctor to learn more about what you can expect from your Abecma treatment.

Below is important information you should consider before receiving Abecma.

Interactions

Taking or receiving a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.

Abecma is not known to interact with other medications, herbs, vitamins or supplements, foods, or alcohol. The drugmaker didn’t list any interactions with these products in the drug’s prescribing information.

Before starting Abecma treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Other interactions

Abecma can interact with other substances, such as:

  • Lab tests: If you’ve received Abecma, certain tests for HIV may return false-positive results. This means that the test reports you have HIV even though you actually do not.
  • Vaccines: You should not receive live vaccines 6 weeks before you prepare to receive Abecma. (Live vaccines contain weakened versions of the bacteria or virus that they’re meant to protect against.) Getting a live vaccine surrounding the time you receive Abecma increases your risk of infection. Examples of live vaccines include measles, mumps, and rubella (MMR), rotavirus, and chickenpox. If you need to receive a vaccine, talk with your doctor to learn when it’s safe to receive it after your infusion.

Pregnancy and breastfeeding

It’s not known whether it’s safe to receive Abecma during pregnancy or while breastfeeding.

Because of how the drug works, it may be harmful to an unborn baby. It’s likely that your doctor will have you take a pregnancy test before you receive Abecma.

If you’re pregnant or breastfeeding or planning either, talk with your doctor before receiving Abecma. Even if you’re considering having children after your Abecma treatment, talk with your doctor before receiving Abecma.

Boxed warnings

Abecma has several boxed warnings, as described below. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

The boxed warnings include:

Risk of developing cytokine release syndrome (CRS) and neurologic toxicity: Abecma helps your body fight multiple myeloma (a type of blood cancer) through your immune system. But sometimes, your immune system overreacts in the process. This causes CRS, which is a potentially fatal condition that has a range of symptoms. If you have a milder case, you may experience fever or chills. But in more severe cases, you could experience symptoms like:

Abecma also may damage your brain or nervous system, which can result in life threatening neurologic toxicity. Mild symptoms include headache and dizziness. More severe symptoms include:

If you develop CRS or neurologic toxicity, your doctor will likely prescribe one or a combination of the following:

Due to the risk of CRS and neurologic toxicity, you’ll stay at the facility where you received Abecma for at least 7 days. Then, you’ll stay close to this facility for 4 more weeks for additional monitoring. Due to the risk of neurologic toxicity, you should not drive or operate heavy duty machines for 8 weeks after your Abecma infusion.

Tell your doctor right away if you’re experiencing symptoms of CRS or neurologic toxicity.

Because of these risks, Abecma is available only through a risk evaluation and mitigation strategy (REMS) program. The FDA requires REMS programs for certain drugs to help ensure they’re used or given safely.

Risk of developing certain dangerous immune system conditions: Abecma may increase your risk of developing certain dangerous immune system conditions. Symptoms of these conditions include problems with your kidneys or other organs and lower levels of oxygen in your body. Due to this risk, your doctor will monitor you closely surrounding the time you receive Abecma.

Risk of having certain blood cell counts that are lower than normal for longer than usual: Abecma may increase your risk of having certain lowered blood cell counts for longer than usual. These include white blood cells and platelets. With low white blood cells, you may have sores on your skin or joint pain. With low platelets, you may experience nosebleeds more easily or have blood in your urine or feces. In certain situations, you may receive a blood transfusion or a myeloid growth factor, such as pegfilgrastim (Neulasta), to help.

Risk of developing certain other cancers: Abecma may raise your risk of developing certain other cancers that involve your T cells. (These cells are part of your immune system). Long after you receive Abecma, your doctor will continue to monitor you for these cancers. If you develop one of these cancers, you’re encouraged to report it to Bristol Myers Squibb (the drugmaker) at 1-888-805-4555.

Other warnings

Abecma can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Abecma is a good treatment option for you.

Talk with your doctor about your health history before you receive Abecma. Be sure to tell them if any of the following factors apply to you:

Other drugs are available that can treat your condition. If you’d like to explore an alternative to Abecma, talk with your doctor. They can tell you about other medications that might work well for you.

Like Abecma, Carvykti (ciltacabtagene autoleucel) is a CAR T-cell therapy that’s used in certain situations to treat multiple myeloma. But other groups of drugs may be prescribed to treat your condition. Talk with your doctor to learn more about treatment alternatives.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.