CD22 Monoclonal Antibody


CD22 Monoclonal Antibody, CD22 Antigen, Moxetumomab pasudotox-tdfk, Lumoxiti, Inotuzumab Ozogamicin, Besponsa

  • Indications
  1. Hairy Cell Leukemia
    1. Moxetumomab pasudotox-tdfk
  2. B Cell precursor Acute Lymphoblastic Leukemia
    1. Inotuzumab Ozogamicin
  • Mechanism
  1. CD22
    1. CD22 is a B Cell lectin and adhesion molecule
    2. CD22 is involved in cell signaling and adhesion to Monocytes and T-Cells
  2. CD22 Monoclonal Antibody
    1. Conjugate antibodies that deliver cytotoxic drugs to CD22 positive cancer cells
  • Medications
  1. Moxetumomab pasudotox-tdfk (Lumoxiti)
    1. Conjugated Monoclonal Antibody that delivers the cytotoxic drug Pseudomonas exotoxin A to cancer cells
    2. Avoid in severe Renal Insufficiency (eGFR <30 ml/min)
    3. Used in Hairy Cell Leukemia
    4. Risks of Hemolytic Uremic Syndrome, capillary leak syndrome, Nephrotoxicity, Electrolyte abnormalities
  2. Inotuzumab Ozogamicin (Besponsa)
    1. Conjugated Monoclonal Antibody that delivers the cytotoxic drug calicheamicin to cancer cells
    2. Used against B Cell precursors in Acute Lymphoblastic Leukemia
    3. Risks of hepatotoxicity and hepatic veno-occlusive disease
  • Dosing
  1. See other references for disease specific dosing protocols
  • Adverse Effects
  • Moxetumomab
  1. Hemolytic Uremic Syndrome
  2. Capillary leak syndrome
  3. Nephrotoxicity
    1. Obtain Renal Function testing before each dose
  4. Infusion Reaction
    1. Premedicate
  5. Electrolyte abnormalities
    1. Obtain Electrolytes before each dose and at 8 days after dose
  6. Other common adverse effects
    1. Gastrointestinal (Nausea, Diarrhea, Constipation)
    2. Headache
    3. Fever
    4. Anemia
  • Adverse Effects
  • Inotuzumab
  1. Infusion Reactions
  2. QTc Prolongation
  3. Hepatotoxicity
    1. Includes hepatic veno-occlusive disease (sinusoidal obstruction)
    2. Increased transaminases, GGT, and Serum Bilirubin
  4. Myelosuppression
    1. Thrombocytopenia
    2. Leukopenia
    3. Neutropenia
    4. Anemia
  5. Other common adverse effects
    1. Fever
    2. Nausea or Vomiting
  • Safety
  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters, Unknown Pregnancy category)
    1. Use reliable Contraception
  3. Monitoring
    1. Renal Function tests
    2. Serum Electrolytes (including Serum Calcium, Serum Phosphorus)
    3. Liver Function Tests (LFTs)