An antibody-chemotherapy treatment for a type of leukaemia
Inotuzumab ozogamicin
An antibody-chemotherapy treatment used for some adults with acute lymphoblastic leukaemia, given into a vein.
What is Inotuzumab ozogamicin?
Inotuzumab ozogamicin is a specialist cancer treatment used for some adults with acute lymphoblastic leukaemia (a cancer of the white blood cells), usually when it has come back or not responded to earlier treatment. It is an antibody joined to a powerful chemotherapy drug: the antibody homes in on a marker called CD22 on the leukaemia cells and delivers the chemotherapy into them. It is given as a drip into a vein in hospital. The most important risks are liver damage, including a serious liver problem called veno-occlusive disease, a drop in blood cells with a risk of infection and bleeding, infusion reactions, and effects on the heart's rhythm. It is used only under close specialist supervision.
Education and reference only. This is a plain-language guide to Inotuzumab ozogamicin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Inotuzumab ozogamicin is a type of treatment called an antibody-drug conjugate, used for some adults with acute lymphoblastic leukaemia, a cancer of the blood and bone marrow. It is mainly used when the leukaemia has returned or has not responded to earlier treatment. It is made of an antibody that recognises a marker called CD22, found on these leukaemia cells, linked to a strong chemotherapy agent. It is given as an infusion into a vein in a specialist cancer unit and is prescribed and supervised by a haematology team.
How it works
The antibody part of inotuzumab ozogamicin attaches to CD22, a marker on the surface of these leukaemia cells. Once attached, the package is taken inside the cell, where the powerful chemotherapy it carries is released and damages the cell's DNA, killing it. The aim is to focus the chemotherapy on the cancer cells. Because the chemotherapy is very potent and the treatment affects healthy bone marrow and the liver, careful monitoring is needed throughout, particularly of the liver.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist treatment used in UK cancer centres for some adults with acute lymphoblastic leukaemia that has come back or not responded to treatment.
Practical use
How to take Inotuzumab ozogamicin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as a drip into a vein in a specialist cancer unit, on a schedule planned by your haematology team.
- Report yellowing of your skin or eyes, a swollen or painful tummy, or sudden weight gain straight away, as these can be signs of liver problems.
- Contact your team urgently if you develop a fever, sore throat, unusual bruising or bleeding, as your blood counts can fall.
- Tell your team about any heart-rhythm problems and other medicines that can affect the heart's rhythm.
- Use reliable contraception during treatment and for as long as your team advises, as it can harm an unborn baby.
Weighing it up
Advantages & disadvantages of Inotuzumab ozogamicin
Advantages
- Targets a marker on leukaemia cells to deliver chemotherapy where it is needed.
- An option for some adults whose leukaemia has come back or not responded to earlier treatment.
- Given as a planned hospital infusion under close specialist care.
Disadvantages
- Can cause serious liver damage, including veno-occlusive disease, especially if a transplant follows.
- Lowers blood counts, raising the risk of infection, bruising and bleeding.
- Can cause infusion reactions and affect the heart's rhythm (the QT interval).
Practical use
Good to know
The most important thing to understand about inotuzumab ozogamicin is its effect on the liver. It can cause serious liver injury, including veno-occlusive disease, in which small blood vessels in the liver become blocked; this risk is especially important if a stem-cell (bone-marrow) transplant is planned afterwards. Signs such as yellowing of the skin or eyes, a swollen or painful tummy, or sudden weight gain should be reported urgently, and liver tests are checked regularly. Because it lowers blood counts, infections, bruising and bleeding are real risks, and any fever must be reported straight away. Reactions during the infusion can happen, so it is given with close watching. It can also affect the heart's electrical rhythm (the QT interval), which is monitored. Like other cancer treatments, it can harm an unborn baby, so reliable contraception is essential during treatment and for a time afterwards.
Who should not take it / use with caution
- People who have had a serious allergic reaction to inotuzumab ozogamicin should not have it.
- It is generally avoided in pregnancy and while breastfeeding because it can harm the baby.
- It is used with great caution, or avoided, in people with significant liver problems, and only under specialist supervision.
Monitoring
- Regular blood tests to check blood counts and liver function.
- Watching closely for signs of veno-occlusive disease, especially around any planned transplant.
- Heart tracing (ECG) and blood salts to watch the QT interval, plus monitoring for infusion reactions and infections.
Side effects
- A fall in blood cells, leading to infections, tiredness, bruising or bleeding.
- Liver problems, including, seriously, veno-occlusive disease, which needs urgent attention.
- Reactions during the infusion, such as fever, chills or a rash.
- Nausea, tiredness, and less commonly changes in the heart's rhythm (the QT interval).
Key interactions
- Other treatments that affect the liver may add to the risk of liver injury, so your team reviews everything you take.
- Medicines that affect the heart's QT interval are reviewed because of the rhythm risk.
- Tell your team about all your medicines, including anything from a pharmacy or herbal products.
Available as: A powder made up into a solution and given as an infusion into a vein.
Answers
Inotuzumab ozogamicin: frequently asked questions
What is inotuzumab ozogamicin used for?
It is used for some adults with acute lymphoblastic leukaemia that has come back or not responded to treatment, by targeting a marker called CD22 to deliver chemotherapy into the cancer cells.
Why does it affect the liver?
It can cause serious liver injury, including veno-occlusive disease where small liver blood vessels become blocked, which is especially important if a transplant is planned, so your liver is closely monitored.
How is it given?
It is given as a drip into a vein in a specialist cancer unit, on a schedule planned and watched over by your haematology team.
Why am I more likely to get infections?
It lowers your blood counts, including infection-fighting cells, so any fever or sign of infection must be reported to your team straight away.
Can I have it during pregnancy?
No. It can harm an unborn baby, so it is avoided in pregnancy and reliable contraception is needed during treatment and for a time afterwards.
Authoritative sources
- BNF
- NICE CKS
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