If you’re looking at treatment options for a certain kind of acute lymphoblastic leukemia (ALL), you may want to learn more about Blincyto. It’s a prescription drug used in adults and some children with ALL. ALL is a type of blood cancer that progresses quickly. Without treatment, ALL may be fatal in a few months.
To learn more about Blincyto’s use for ALL, see the “What is Blincyto used for?” section below.
Blincyto contains the active ingredient blinatumomab. (An active ingredient is what makes a drug work.) Blincyto comes as a powder that your doctor will mix into a liquid solution. You’ll receive Blincyto as an intravenous (IV) infusion (an injection into a vein over a period of time).
Blinatumomab belongs to the group of drugs called monoclonal antibodies. It’s a biologic medication, which means it’s made from parts of living cells. Blinatumomab isn’t available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.) Instead, blinatumomab comes only as the brand-name drug Blincyto.
Read on to learn more about Blincyto’s uses, side effects, and more.
Like most drugs, Blincyto may cause mild or serious side effects. The lists below describe some of the more common side effects that Blincyto may cause. These lists don’t include all possible side effects.
Keep in mind that a drug’s side effects can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Blincyto. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Blincyto can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Blincyto’s prescribing information.
Mild side effects of Blincyto that have been reported include:
- skin rash
- low blood pressure
- insomnia (trouble sleeping)
- back pain
- infusion-related reaction, including itchiness or muscle pain
- low level of red blood cells
- low level of platelets (cells that help with blood clotting)
- weight gain
- mild allergic reaction*
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 or pharmacist.
* To learn more about this side effect, see the “Allergic reaction” section below.
Serious side effects
Serious side effects from Blincyto can occur, but they aren’t common. If you have serious side effects from Blincyto, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Blincyto that have been reported include:
- very high fever
- low levels of neutrophils (a type of white blood cell)
- serious infection
- abnormal heart rhythm
- tumor lysis syndrome
- inflammation of the pancreas
- boxed warnings: risk of cytokine release syndrome and neurological toxicity *
- severe allergic reaction†
* For more information, see the “Boxed warnings” section at the beginning of this article.
† To learn more about this side effect, see the “Allergic reaction” section below.
Some people may have an allergic reaction to Blincyto.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Blincyto. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Find answers to some commonly asked questions about Blincyto.
Is Blincyto chemotherapy?
No, Blincyto isn’t chemotherapy. Blincyto is a cancer drug, but it works differently than chemotherapy.
Chemotherapy is a type of treatment that kills cancer cells or prevents them from growing. But because chemotherapy isn’t a targeted treatment, it can destroy both cancer cells and healthy cells. This may cause many side effects.
Blincyto is a kind of targeted therapy called a monoclonal antibody. Unlike chemotherapy, it kills cancer cells only.
What is Blincyto’s mechanism of action (how does it work)?
Blincyto works by causing certain cells in your immune system (called T cells) to kill cancer cells. The drug attaches both to the T cells and the cancer cells. By binding to these two cells, Blincyto activates the T-cell, which is responsible for destroying the cancer cells.
If you have other questions about how Blincyto works to treat your condition, talk with your doctor.
Is Blincyto used to treat DLBCL?
Blincyto isn’t approved to treat diffuse large B-cell lymphoma (DLBCL). But Blincyto may be prescribed off-label to treat this condition. (Off-label drug use occurs when a drug is prescribed for a purpose other than what it’s approved for.)
Doctors sometimes prescribe Blincyto to treat DLBCL if other approved drugs haven’t been effective. A small study showed that Blincyto may be effective for treating DLBCL in some people. But more research is needed to confirm the drug’s effectiveness for this condition.
To learn more about DLBCL treatment options, talk with your doctor.
Prescription drug costs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called Amgen Assist 360 may also be available.
You can also check out this article to learn more about saving money on prescriptions.
Your doctor will recommend the dosage of Blincyto that’s right for you. Below are commonly used dosages, but your doctor will determine the dosage you receive.
Form and strength
Blincyto comes as a powder that your doctor will mix into a liquid solution. The drug is available in one strength: 35 micrograms (mcg).
Your doctor will calculate your Blincyto dose based on your weight or body surface area in square meters.
Blincyto is given in treatment cycles. Your doctor will prescribe either four or five cycles, depending on your condition. A Blincyto treatment cycle consists of 28 days of intravenous (IV) infusions, then 14 or 56 days of no treatment. (An IV infusion is an injection into a vein over a period of time.)
Questions about Blincyto’s dosing
Below are some common questions about Blincyto’s dosing.
- What if I miss a dose of Blincyto? If you miss an appointment to receive a Blincyto infusion, call to reschedule your treatment as soon as possible. Missing a dose of Blincyto may make the treatment less effective.
- Will I need to use Blincyto long term? It’s possible that you’ll use Blincyto long term. Your doctor will prescribe Blincyto in treatment cycles. Depending on your condition, you’ll need either four or five treatment cycles. Ask your doctor how long you’ll need to use Blincyto.
- How long does Blincyto take to work? After you receive a dose, Blincyto starts working right away to treat your cancer. But it’s unlikely that you’ll feel the drug working in your body. You’ll have tests done to check whether the drug is working for you. It may take several weeks or months before these tests show the effects of Blincyto.
Your doctor will explain how Blincyto will be given to you. They’ll also explain how much you’ll be given and how often.
Blincyto comes as a powder that your doctor will mix into a liquid solution. You’ll receive Blincyto as an intravenous (IV) infusion (an injection into a vein over a period of time). You’ll receive infusions at your doctor’s office, at another healthcare facility, or at home.
If you have questions about what to expect at your Blincyto infusion appointments, talk with your doctor.
Receiving Blincyto with other drugs
You’ll be given certain medications before receiving Blincyto. These medications can help lower your risk of side effects with Blincyto. Depending on your specific condition and treatment plan, you may receive prednisone (Rayos) or dexamethasone (Hemady). These medications may be given by IV injection, or they may be given as pills that you swallow, depending on what your doctor prescribes for you.
Questions for your doctor
You may have questions about Blincyto and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Blincyto affect me?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
Blincyto is used to treat a type of acute lymphoblastic leukemia (ALL) called CD19-positive B-cell precursor ALL. It’s used in adults and in some children as young as 1 month old.
Doctors prescribe Blincyto for certain people with cancer that is in remission. (With remission, your cancer isn’t causing symptoms, but it’s still detected on cancer tests.) It’s important to note that the Food and Drug Administration has given Blincyto accelerated approval for this use. With accelerated approval, the FDA approves a drug based on information from early studies. Other studies are still ongoing, and the FDA’s decision for full approval will be made once they are complete.
You may also be prescribed Blincyto if your cancer has relapsed or is refractory. (With relapsed ALL, your cancer has returned after receiving treatment. If your cancer is refractory, it hasn’t improved with other treatments.)
ALL is a type of blood cancer. It’s a fast-growing cancer that starts in the lymphocytes, a type of white blood cell found in the bone marrow.
Blincyto helps treat ALL by activating certain cells in the immune system, which then destroy the cancer cells.
When considering treatment with Blincyto, some important things to discuss with your doctor include:
- your overall health
- any medical conditions you may have
Additionally, tell your doctor if you’re taking any medications. This is important to do because some medications can interfere with Blincyto.
These and other considerations to discuss with your doctor are described below.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before taking Blincyto, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Blincyto.
For information about drug-condition interactions, see the “Other warnings” section below.
Interactions with drugs or supplements
Blincyto can interact with several types of drugs. These drugs include:
- certain blood thinners, including warfarin (Jantoven)
- certain drugs that affect your immune system, such as cyclosporine (Sandimmune)
This list does not contain all types of drugs that may interact with Blincyto. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Blincyto.
Blincyto can interact with live vaccines. (Live vaccines contain weakened, live forms of the virus they’re meant to protect you from.) You should not get live vaccines during your Blincyto treatment or in the 2 weeks before starting treatment. Examples of live vaccines include:
Before getting a live vaccine, you’ll need to wait for your immune system to recover after receiving your last dose of Blincyto. Your doctor can let you know when you can receive a live vaccine after your Blincyto treatment ends.
Before starting Blinctyo treatment, talk with your doctor or pharmacist about any vaccines you may need.
Blincyto has two
Boxed warnings include:
Risk of cytokine release syndrome (CRS). Some drugs that act on the immune system, such as Blincyto, can cause CRS. This condition occurs when the body quickly releases a large amount of cytokines (proteins) into your blood. CRS can cause fever, nausea, low blood pressure, and fast heartbeat. CRS is mild in most people, but in rare cases, it can be severe and even life threatening. If you experience any symptoms of CRS during your Blincyto treatment, tell your doctor right away. You may need to stop your Blincyto treatment temporarily or permanently. Your doctor may also prescribe steroids to help reduce your side effects.
Risk of neurotoxicity. Blincyto may cause neurotoxicity (damage to the nervous system, which includes the nerve cells and brain). This is a common Blincyto side effect. Some neurotoxicities, such as loss of consciousness and seizures, can be life threatening.
Symptoms of neurotoxicity reported with Blincyto include:
- severe muscle tremor
- encephalopathy (brain damage)
- trouble speaking
- loss of consciousness
- confusion or dizziness
If you have symptoms of neurotoxicity, your doctor may have you temporarily or permanently stop your Blincyto treatment.
Blincyto may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Blincyto is a good treatment option for you.
Talk with your doctor about your health history before you take Blincyto. The list below includes factors to consider.
- Past radiation therapy or leukemia chemotherapy. Before starting Blincyto treatment, tell your doctor if you’ve had radiation therapy or chemotherapy for leukemia in the past. Receiving Blincyto if you’ve had these kinds of treatment before could raise your risk of a kind of nerve damage called leukoencephalopathy.
- Allergic reaction. If you’ve had an allergic reaction to Blincyto or any of its ingredients, your doctor will likely not prescribe Blincyto. Ask them what other medications are better options for you.
- Neurological problems. Before receiving Blincyto, tell your doctor if you have neurological problems such as seizures, confusion, or loss of balance, or if you’ve had these issues in the past. Blincyto has a boxed warning for neurotoxicity. It isn’t known if Blincyto is safe for people with neurological problems. Your doctor can determine whether Blincyto is safe for you to take.
- Infection. Infections are a common side effect of Blincyto. In some cases, these infections can be severe or life threatening. If you have an infection before starting Blincyto treatment, the drug may make it worse. Tell your doctor if you’re feeling unwell before receiving your first Blincyto dose. You may need to take antibiotics before or during your Blincyto treatment to treat the infection.
- Previous infusion reaction. If you’ve ever had an infusion reaction with another medication, you might have a higher risk of a similar reaction with Blincyto. Infusion reactions are side effects that can occur during or after receiving an intravenous (IV) infusion. Examples of infusion reactions include swelling of the face, high or low blood pressure, fever, and skin rash. If you’ve had an infusion reaction with another drug, tell your doctor before starting your Blincyto treatment.
Blincyto and alcohol
Blincyto isn’t known to interact with alcohol. If you have questions about drinking alcohol during your Blincyto treatment, talk with your doctor or pharmacist.
Pregnancy and breastfeeding
Blincyto isn’t safe to use in pregnancy. Blincyto use during pregnancy hasn’t been studied, but it’s possible that the drug could cause harm to a fetus.
If you can become pregnant, your doctor will have you take a pregnancy test before starting your Blincyto treatment. You’ll also need to use birth control during your treatment and for 48 hours after your last dose.
If you’re pregnant or planning to become pregnant, talk with your doctor about treatment options other than Blincyto. If you become pregnant during your Blincyto treatment, tell your doctor right away.
It’s unknown whether Blincyto is safe for someone who’s breastfeeding. But because of the risk of harm to a breastfed child, you should not breastfeed during treatment or for 48 hours after your last dose.
If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Receiving too much Blincyto can lead to serious side effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
Although the risk of an overdose of Blincyto is rare, it could be life threatening if it occurs. In a study involving children with acute lymphoblastic leukemia receiving Blincyto, one person died from heart failure after receiving an amount higher than the maximum recommended dose.
What to do in case you receive too much Blincyto
If you think you’ve received too much Blincyto, call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
If you have questions about receiving Blincyto, talk with your doctor or pharmacist. Some questions you may want to ask your doctor include:
- Will I lose my hair or nails with Blincyto treatment?
- How long do I need to stay in the hospital for Blincyto treatment?
- After receiving a Blincyto infusion, can I drive home?
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.