Inotuzumab ozogamicin
ADCs
Antibody-drug conjugates (ADCs)High alert
An error with this medicine can cause serious harm: double checks and protocols are used.Pregnancy: avoid
Avoid in pregnancy. It may harm the fetus: a pregnancy test is done first, women and men use contraception during and for months after treatment, and breastfeeding is stopped.
An anti-CD22 antibody carrying calicheamicin; used in relapsed or refractory B-cell acute lymphoblastic leukaemia. Watch the liver.
Quick facts
- Group
- Antibody-drug conjugates (ADCs)
- Target
- CD22 on B-lymphoblasts
- Key effects
- Fatigue · Nausea · Mouth sores
- Monitor
- Liver tests · Complete blood count
- ATC
- L01FB01
No doses: the clinician sets them by the current guideline.
Mechanism of action
Inotuzumab ozogamicin is an antibody-drug conjugate. The antibody binds CD22 on the surface of B-lineage blasts; the complex is internalised and calicheamicin is released inside the cell, where it breaks double-stranded DNA and triggers cell death.
- The antibody binds CD22 on B-lymphoblasts
- It is internalised and calicheamicin is released
- Double-strand DNA breaks kill the blast
Indications
- Relapsed or refractory CD22-positive B-cell precursor acute lymphoblastic leukaemia in adults and children from one year of age. Acute leukaemia (AML and ALL) →
Adverse effects
Common
- Fatigue, fever
- Nausea, abdominal pain, diarrhoea, constipation
- Mouth sores, decreased appetite
- Headache, back or limb pain
Contraindications
- Hypersensitivity to inotuzumab ozogamicin; earlier liver disease or a prior stem cell transplant raise the risk of veno-occlusive disease
Key interactions
- Drugs that prolong the QT interval, low potassium or magnesium
- Add to QT risk; ECG and electrolytes are checked.
What is monitored
- Liver tests, bilirubin, weight and abdominal girth
- Complete blood count
- ECG and electrolytes
- Vital signs during and for at least an hour after infusion
Administration and safety
- Hazardous drug, prepared and infused intravenously by trained staff.
- Premedication before each dose.
- Look-alike names: inotuzumab ozogamicin and gemtuzumab ozogamicin are different; the order is checked.
Pregnancy and breastfeeding
Avoid in pregnancy. It may harm the fetus: a pregnancy test is done first, women and men use contraception during and for months after treatment, and breastfeeding is stopped.
Nursing care
- Give premedication and watch for fever, chills, rash or breathlessness during and after infusion.
- Weigh daily; teach to report rapid weight gain, right upper abdominal pain or jaundice.
- Teach to report fever, bleeding or palpitations.
- Contraception during and for months after treatment by women and men; breastfeeding is stopped.
Pharmacokinetics
- Absorption
- Intravenous infusion over about an hour, on set days of each cycle.
Test yourself
Think of the answer, then tap the question to see it.
Which antigen does inotuzumab ozogamicin target?
CD22 on B-lymphoblasts.
What are its two boxed warnings?
Hepatic veno-occlusive disease and higher non-relapse mortality after stem cell transplant.
Which leukaemia is it used for?
Relapsed or refractory B-cell precursor acute lymphoblastic leukaemia.
Connections
← Back to the class: Antibody-drug conjugates (ADCs)
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Inotuzumab Ozogamicin Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2024); Inotuzumab Ozogamicin - NCI (National Cancer Institute, 2024); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.