[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/) › Blinatumomab # Blinatumomab ## Antineoplastic monoclonal antibodies? Antineoplastic monoclonal antibodies ## High alert? An error with this medicine can cause serious harm: double checks and protocols are used. A bispecific antibody that links T cells (CD3) to B-lineage leukaemia cells (CD19) to kill them; used in B-cell ALL. Risks: cytokine release and neurotoxicity. Updated Nov 1, 2026 Also called: bispecific T-cell engager (BiTE) ## Quick facts **Group** [Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/) **Target** CD19 on B cells and CD3 on T cells **Key effects** Fever · Infusion reactions · Oedema **Monitor** Temperature · Neurological checks **ATC** L01FX07 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action Blinatumomab is a small fusion protein made of two antibody binding sites: one for CD19 on normal and malignant B-lineage cells and one for CD3, part of the T-cell receptor complex. It bridges a T cell to the leukaemic cell, independent of MHC antigen presentation, so the T cell releases its cytotoxic granules and kills the CD19-positive cell; T cells proliferate and release cytokines, which explains cytokine release syndrome. - One arm binds CD19 on leukaemic B cells - The other arm binds CD3 on T cells - T cell kills the B cell without MHC presentation - T-cell activation releases cytokines (CRS risk) ## Indications - B-cell precursor acute lymphoblastic leukaemia: relapsed or refractory, with measurable residual disease, or as consolidation in remission. [Acute leukaemia (AML and ALL) →](https://durgical.com/en/conditions/acute-leukaemia/) ## Adverse effects ### Common - Fever, headache, tremor - Infusion reactions - Oedema - Diarrhoea, mouth sores - Low neutrophils ### Serious (rare, important) - Cytokine release syndrome (boxed warning) - Neurological toxicity: confusion, speech problems, seizures (boxed warning) - Serious infections and febrile neutropenia - Pancreatitis ## Contraindications - Known allergy to blinatumomab - Caution: history of seizures or other central nervous system disease ## Key interactions **Live vaccines** Not given shortly before, during or after treatment until immune recovery. ## What is monitored - Temperature, blood pressure and oxygen during the first days of each cycle (cytokine release) - Neurological checks: handwriting, speech, orientation - Blood counts and signs of infection - Lipase if abdominal pain ## Administration and safety - Continuous intravenous infusion through an infusion pump; the pump, bag and rate are double-checked at every bag change. - Premedication is given before the start of each cycle and dose step-ups, as ordered. - The first days of each cycle, and dose increases, are often done in hospital to watch for cytokine release and neurotoxicity. ## Pregnancy and breastfeeding May harm the fetus; contraception is used during treatment and for a period after. ## Nursing care - Vital signs often during the first days of each cycle; report fever, low blood pressure or low oxygen at once. - Neurological checks each shift (writing a sentence, speech, orientation). - Protect the line: the infusion is not stopped or changed without instructions. - Teaching for home infusion: do not drive, report fever, confusion, shaking or trouble speaking, and keep the pump connected. ## Pharmacokinetics **Absorption** Continuous intravenous infusion through a pump, in cycles of several weeks. **Elimination** Broken down as a protein. ## Memory aid «BLINatumomab LINKS a T and a B»: CD3 + CD19. Its two boxed dangers are «Cytokines and Confusion». ## Test yourself Think of the answer, then tap the question to see it. ## Which two antigens does blinatumomab bind? CD19 on B-lineage cells and CD3 on T cells. ## What are the two boxed warnings of blinatumomab? Cytokine release syndrome and neurological toxicity. ## How is blinatumomab given? As a continuous intravenous infusion through a pump, in cycles. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/blinatumomab/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **High alert** An error with this medicine can cause serious harm: double checks and protocols are used. ## Connections ## Related drugs 1 - [Rituximab](https://durgical.com/en/pharmacology/rituximab/) ## Related conditions 1 - [Acute leukaemia (AML and ALL)](https://durgical.com/en/conditions/acute-leukaemia/) [← Back to the class: Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Blinatumomab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a614061.html) (MedlinePlus (U.S. National Library of Medicine), 2024); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01FX07) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/blinatumomab/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/blinatumomab/