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Systemic Anti-Cancer Therapy Regimen Library

Home > LEU ALL precursor B-cell - blinatumomab [CNS1 and CNS2]

LEU ALL precursor B-cell - blinatumomab [CNS1 and CNS2]

Treatment Overview

This regimen is intended for patients with CNS1+ or 2+ and minimal residual disease post chemotherapy as bridge to allogeneic stem cell transplant.

Cycle 1 - 35 days

Cycle length:
35

dexamethasone:

  • Administer 30 minutes prior to the start of blinatumomab infusion.
  • Repeat dose if restarting blinatumomab infusion after an interruption of 4 hours or more.

Intrathecal metHOTREXATe: For Ommaya reservoir reduce dose to 6 mg intraventricularly.

Cycle details

Cycle 1 - 35 days

Medication Dose Route Days Max Duration
dexamethasone 20 mg flat dosing oral administration 1
blinatumomab 15 microgram/m² intravenous 1 to 28 24 hours Min: 24 hours
metHOTREXATe * 15 mg intrathecal injection 8, 29

dexamethasone:

  • Administer 30 minutes prior to the start of blinatumomab infusion.
  • Repeat dose if restarting blinatumomab infusion after an interruption of 4 hours or more.

Intrathecal metHOTREXATe: For Ommaya reservoir reduce dose to 6 mg intraventricularly.

Full details

Cycle 1 - 35 days

Day: 1

Medication Dose Route Max duration Details
dexamethasone 20 mg flat dosing oral administration
Instructions:
  • 30 minutes prior to blinatumomab infusion.
  • Repeat dose if restarting blinatumomab infusion after an interruption of 4 hours or more.
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 2

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 3

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 4

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 5

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 6

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 7

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 8

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.
metHOTREXATe * 15 mg intrathecal injection
Instructions:
  • Adhere to local institution policy for intrathecal administration.
  • For Ommaya reservoir reduce dose to 6 mg intraventricularly.

Day: 9

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 10

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 11

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 12

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 13

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 14

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 15

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 16

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 17

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 18

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 19

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 20

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 21

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 22

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 23

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 24

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 25

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 26

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 27

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 28

Medication Dose Route Max duration Details
blinatumomab 15 microgram/m² intravenous 24 hours Min: 24 hours
Instructions:
  • Continuous infusion over 24 hours.
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.2 micron.

Day: 29

Medication Dose Route Max duration Details
metHOTREXATe * 15 mg intrathecal injection
Instructions:
  • Adhere to local institution policy for intrathecal administration.
  • For Ommaya reservoir reduce dose to 6 mg intraventricularly.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
Emetogenicity: Minimal
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended
Irradiated blood components: Irradiation of blood components is recommended
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis recommended

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

References

Amgen Australia Pty Ltd Blincyto Australian Product Information v0.8 12 August 2022 https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2015-PI-02791-1&d=20221011172310101 (accessed 12 October 2022).

Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.