Monoclonal Antibodies to Treat Acute Lymphocytic Leukemia

Antibodies are proteins made by the body’s immune system to help fight infections. Man-made versions, called monoclonal antibodies, can be designed to attack a specific target, such as a protein on the surface of lymphocytes.

Blinatumomab (Blincyto)

Blinatumomab is a special kind of monoclonal antibody because it can attach to 2 different proteins at the same time. One part of blinatumomab attaches to the CD19 protein, which is found on B cells, including some leukemia and lymphoma cells. Another part attaches to CD3, a protein found on immune cells called T cells. By binding to both of these proteins, this drug brings the cancer cells and immune cells together, which is thought to cause the immune system to attack the cancer cells.

This drug is used to treat some types of B-cell ALL, typically after chemotherapy has been tried. It is given into a vein (IV) as a continuous infusion over 28 days. It may be repeated again for more cycles with 2 weeks off in between. Because of certain serious side effects that occur more often during the first few times it is given, the patient usually needs to be treated in a hospital or clinic for the beginning of at least the first 2 cycles.

The most common side effects are fever, headache, swelling of the feet and hands, nausea, tremor, rash, constipation, and low blood potassium levels. It can also cause low white blood cell counts, which increase the risk of serious infection.

This drug can also cause neurologic problems, such as seizures, difficulty in speaking or slurred speech, passing out, confusion, and loss of balance.

Some patients have serious reactions during the infusion of this drug. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), headache, nausea, fever or chills, shortness of breath, and/or wheezing. Let you healthcare team know if you develop any of these symptoms, as this reaction can be life-threatening. If you do have a reaction, the drug will be stopped while the reaction is treated.

Inotuzumab ozogamicin (Besponsa)

This drug is an anti-CD22 antibody linked to a chemotherapy drug. B cells (including some leukemia cells) usually have the CD22 protein on their surface. The antibody acts like a homing signal, bringing the chemo drug to the leukemia cells, where it enters the cells and kills them when they try to divide into new cells.

This drug is used to treat some types of B-cell ALL, typically after chemotherapy has been tried. It is given as an infusion into a vein (IV), once a week for 3 or 4 weeks in a row. This may be repeated for more cycles. 

The most common side effects are low levels of blood cells (with increased risks of infection, bleeding, and fatigue), fever, nausea, headache, abdominal (belly) pain, and high blood levels of bilirubin (a substance in bile).

Less common but more serious side effects can include:

  • Severe liver damage, including veno-occlusive disease (blockage of veins in the liver)
  • Reactions during the infusion (similar to an allergic reaction). You will likely be given medicines before each infusion to help prevent this.
  • Serious or life-threatening infections, especially in people who have already had a stem cell transplant
  • Changes in the rhythm of the heart

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Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: December 2, 2014 Last Revised: August 18, 2017