Mabcampath (Alemtuzumab)

How does it work?

Mabcampath is usually given to people who have B-cell CLL (chronic lymphocytic leukaemia). It is normally given to patients whose CLL has returned after another treatment or who are not responding to their current chemotherapy. It is also being used to treat other types of cancer in clinical trials.

Mabcampath is a type of monoclonal antibody. Mabcampath finds the protein on leukaemic white blood cells called CD52 and attaches to it. By doing this, the body´s immune system then recognises the cancer cells and helps to kill them. Mabcampath attaches onto cancerous and non cancerous white blood cells, and therefore causes damage to both. However, the normal white blood cells are quickly replaced and in this way the risk of side effects are low.

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What does it look like ?

Mabcampath is a colourless fluid.

How is it given?

Mabcampath is given into your vein through a fine tube called a cannula. You will receive more of the drug each day, usually over three to seven days. Your doctor may refer to this as dose escalation. Normally once the ideal dose is reached, the treatment is given three times a week and most patients will have the treatment for 4-12 weeks.

Before receiving Mabcampath, you may be given other drugs to reduce the risk of side effects. Also your first few doses of Mabcampath will be given slowly. If you do have a reaction, your treatment can be slowed down or stopped and slowly restarted when you are feeling better.

Mabcampath can also be given as an injection under the skin. Your doctor will discuss if this is suitable for you.

Side effects

Every person receiving Mabcampath tolerates it differently. It is difficult to predict what side effects you might have, if any. Below is a list of the more common side effects. Rarer side effects are not mentioned. If you experience any symptoms that you think are related to Mabcampath it is important to tell your doctor or nurse.

You may be asked to stay in hospital for some time after your treatment; this is to monitor you for early side effects. We have divided the side effects into two groups, early (those which occur during the treatment or immediately afterwards) and later (those which occur a few weeks after treatment).

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Early side effects:

Allergic reactions:

Allergic reactions are common with Mabcampath. For this reason you will be monitored carefully and given drugs before your treatment to reduce the risk of side effects. If you experience any of the following, tell your doctor or nurse immediately: breathlessness, wheezing, swollen feeling in the throat or around your tongue, irritation of your nose, coughing, skin itching or rashes.

Remember, you will be monitored carefully by your doctor or nurse and if a reaction does occur, your treatment can be slowed down or stopped and slowly restarted when you are feeling better.
If you are going to have a reaction, it is more likely to occur during your first treatment. However the early side effects should get better within a couple of hours. Your doctor or nurse will monitor you during this time.

Low blood pressure:

Mabcampath sometimes causes a drop in blood pressure, for this reason your blood pressure will be monitored throughout your treatment. It is important to tell your doctor if you are taking medications for your blood pressure before starting your treatment, these may need to be adjusted.

Flu like symptoms:

Tell your doctor or nurse if you have any flu like symptoms, such as fever or chills, weakness, sweating, tiredness, dizziness or headaches. If these side effects do occur they will get better after the treatment has been given.

Feeling sick (nausea):

If you feel sick (nausea) or begin vomiting, tell your doctor who can prescribe anti-sickness (anti-emetic) drugs to control this.

Later side effects:

Mabcampath treatment can be given over several weeks. During this time, you may notice the following side effects occurring.

Damage to your bone marrow:

Mabcampath affects your bone marrow, where you blood cells are made. This causes a reduction in some blood cells. This is explained in more detail below.

Lowered resistance to infection:

As mentioned previously, Mabcampath can affect your (non-cancerous) white blood cells, which normally fight infection. White blood cells are made in your bone marrow. Therefore while receiving Mabcampath you are more prone to viral and bacterial infections. The risk is at its highest when you are receiving treatment and for approximately two months afterwards. To protect you during this time, your doctor will prescribe antibiotic and antiviral medications. You will have regular blood tests to monitor your white cells. Some patients have a reduced number of white cells for up to a year after their treatment and they may need to continue antibiotic or antiviral medications for longer.

While you will receive medications to stop you from getting an infection, there is still a small risk. Therefore it is very important that you tell your doctor or nurse if you feel unwell in any way while receiving Mabcampath and for several months afterwards.

Lowered platelets:

Mabcampath affects the platelets in your blood. Platelets are also made in your bone marrow. Platelets help the blood to clot and control bleeding. A reduced number of platelets means you are more prone to bleed. It is very important to tell your doctor or nurse if you have nosebleeds, bleeding gums, unexplained bruising on your body, bloodshot eyes or any other signs of bleeding. Your platelets will be monitored during regular blood tests.

Diarrhoea:

If you experience diarrhoea, let your doctor or nurse know. You will be prescribed medications to control this. It is also very important to drink plenty of fluids while you have diarrhoea.

It is important to remember that all side effects are milder if you receive your Mabcampath as an injection under your skin.

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Less common side effects:

Breathlessness:

If you are having breathing problems or develop a cough while on your treatment, tell your doctor or nurse.

Constipation:

If constipation becomes a problem for you, let your doctor know. A high fibre diet and plenty of fluids should help relieve this. However you may also need medications called laxatives; your doctor can prescribe these.

Pain:

Some patients complain of pain in their muscles or joints. Tell your doctor who can prescribe painkillers to help control this for you.

Skin problems:

Rashes can appear while receiving Mabcampath, make sure and show this to your doctor or nurse.

Sweating:

If you notice you are sweating more than usual, and this may cause you to become itchy, tell your doctor or nurse. This can occur as a side effect of Mabcampath.

Rarely, some patients experience more serious side effects as a result of Mabcampath. Always tell your doctor or nurse if you are experiencing anything that you think might be a side effect of Mabcampath.

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Other information:

  • If you are on any blood pressure medications, be sure to tell your doctor before starting Mabcampath treatment.
  • It is also important that your doctor is aware of all other medications you are taking before starting Mabcampath, whether prescriptive or non prescriptive.
  • Tell your doctor of any allergies that you might have, drug related or other.
  • Tell your doctor if you have any heart problems, as you may not be suitable to receive Mabcampath.
  • If you are pregnant, breastfeeding or thinking of becoming pregnant, tell your doctor. It is not known what effect Mabcampath has on an unborn baby therefore it is recommended that you or your partner do not get pregnant during the course of Mabcampath or for one year afterwards. Your doctor or nurse can discuss this further with you and recommend an appropriate type of contraceptive.
  • While receiving Mabcampath, it is recommended that you do not receive live vaccinations. Your doctor can discuss this further with you.
  • If you have an infection or lowered immune system, for example if you are HIV positive, Mabcampath may not be suitable for you. Again discuss this with your doctor.

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