2022 Volume 59 Issue 3 Pages 281-286
Blinatumomab is a bispecific T-cell-engaging antibody construct, which is highly effective for patients with relapsed/refractory CD19+ B-cell acute lymphoblastic leukemia. Owing to its distinct toxic profiles compared with conventional chemotherapies, especially its very low rate of hematological toxicities, blinatumomab can offer a higher quality of life (QOL) to patients undergoing this treatment. However, blinatumomab requires continuous infusion for 28 days per cycle owing to its short half-life; therefore, the drug is usually given in an inpatient setting in Japan. To further improve patients’ QOL, we have worked on introducing blinatumomab administration with an ambulatory infusion pump to treat patients in an outpatient setting. We have successfully applied this to two cases so far. A medication cassette reservoir filled with blinatumomab was replaced twice a week on the same day of the week by preparing three-day and four-day medications, alternately. Materials such as the medication cassette reservoir, infusion route, and filter are required, but note that products using materials unsuitable for blinatumomab should be avoided. We once experienced a liquid leakage from the filter in the beginning, but the issue was solved by replacing the filter with another type of external filter. Blinatumomab infusion was possible while the patient is showering without discontinuation by placing the infusion pump in a waterproof bag and by covering the external filter with a waterproof film. From our experiences, blinatumomab can be safely administered in an outpatient setting using an ambulatory infusion pump, which is expected to contribute to an improvement of the patient’s QOL during therapy.
