Info

🌱 來自：relapse refractory of treatment of acute lymphoblastic leukemia (ALL)

blinatumomab

bispecific T-cell-engaging (BiTE) antibody against CD19 bli-na-TUMO-mab

• Mechanism:

  • Binds CD19 on malignant B-cells & CD3 on T-cells

• Dosing:

  • Cycle 1:9-mcg continuous infusion daily (d 1-7),
  • followed by 28-mcg continuous infusion daily (d 8-28); cycle 2-5: 28-mcg continuous infusion daily (1-28) every 6 wks;. Cycles for MRD: 28-mcg continuous infusion

• PK/PD: T1/2 ∼2 h

• AEs: CRS, neurologic tox, fever, peripheral edema, diarrhea, ↑ liver enzymes

• DDI: No known pathways of metabolism, avoid live, & inactivated vaccines

• Clinical pearls:

  • Admission required for initiation & for subsequent cycles for varying duration dependent on disease burden

• CD19 BiTE-bispecific T-cell engager; NEJM2017;376:836

• B 型白血病：百利妥(Blinatumomab, Blincyto)

• 健保給付使用在頑固型或是復發型的 B 細胞型急性淋巴性白血病。

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• 雙特異性 T 細胞接合器，
• 引導體內 CD3 T cell，
• 🚫具有 CD19 標記的 B 細胞 (急性淋巴性白血病的癌細胞) 為目標

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• 進行連結，活化內生的 T 細胞
• 活化的 T 細胞會影響癌細胞的突觸生成
• 進而增加 ↑ 細胞黏附分子
• 產生 ↪ 細胞溶蝕蛋白與釋出發炎性細胞激素
• 最終使具有 CD19 標記的癌細胞導向死亡

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• relapse refractory of treatment of acute lymphoblastic leukemia (ALL)
• acute lymphoblastic leukemia
• Monoclonal Antibodies