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This information is about a drug called gemtuzumab, which is also known as Mylotarg®. It is still being researched as a treatment for people with cancer.
The information describes Mylotarg, how it is given and some of its possible side effects. It should ideally be read with our general information about your type of cancer|.
Mylotarg is a type of cancer drug known as a monoclonal antibody|. It's mainly used as part of research trials to treat some types of acute myeloid leukaemia (AML).| At present it has not been approved for use outside of clinical trials in the UK, so it's not generally available.
When a drug is being developed it has to go through various stages of research called clinical trials| or studies. These aim to establish:
The trials also find out:
At this stage, Mylotarg is only available to a small number of people in the UK, usually in clinical trials. In certain circumstances it may also be given to individual patients who have been selected by their doctor as suitable. This is called a named-patient basis.
Many drugs that are thought to be promising may be found not to be as good as existing treatments or to have side effects that outweigh any benefits. For this reason, doctors and other medical staff carry out frequent and careful checks on the progress of each patient who is having one of these developmental drugs.
If you're taking a developmental drug your doctor will explain about it, the procedures being used and how you'll be looked after while you're taking it. If at any time you have concerns, you should ask your doctor or nurse for information and advice.
Monoclonal antibodies are used to try to destroy some types of cancer cells while causing little harm to normal cells. They are designed to recognise certain proteins that are found on the surface of some cancer cells.
The monoclonal antibody recognises the protein and locks on to it like a key in a lock. Mylotarg locks on to a specific protein called CD33, which is found on the surface of leukaemia cells and certain developing white blood cells (myeloid cells).
Sometimes monoclonal antibodies have a cancer drug attached to them. They can then be used to deliver treatment directly to the cancer cells (targeted therapy).
Mylotarg is a type of targeted therapy. It carries a chemotherapy| drug called ozogamicin directly to the cancer cells. As the chemotherapy is only delivered to cells showing the CD33 protein, it may not affect normal cells within the body.
Mylotarg is a colourless fluid.
Mylotarg is given as a drip (infusion) into a vein (intravenously) through a fine tube (cannula). It can also be given through a central line|, which is inserted under the skin into a vein near the collarbone, or through a PICC line|, which is inserted into a vein in the crook of your arm.
Each infusion is given over approximately two hours. As the best way to give Mylotarg is not yet known, the number of doses and how often they are given will be decided by your doctor. Mylotarg is sensitive to light and is protected from the light when being given.
Each person's reaction to cancer treatment is different. Some people have few side effects while others may experience more. The side effects described here won't affect everyone having this treatment.
We've outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed here, discuss them with your doctor or specialist nurse.
Side effects fall into two groups:
It is possible to have an allergic reaction to Mylotarg, usually during the infusion or within two hours of receiving it. The symptoms of this may be mild to moderate or more severe. Signs of a more severe reaction may include skin rashes and itching, a feeling of swelling of the tongue or throat, irritation of the nasal passages, wheezing, a cough and breathlessness|. You'll be monitored closely during and after your treatment, but it is very important to tell your nurse or doctor if you have any of these effects.
To reduce the chance of developing an allergic reaction, anti-allergy drugs are given before the infusion and may also be repeated afterwards. The infusion can also be slowed down or stopped until the reaction is over.
Once the treatment has ended, the reaction generally gets better within a few hours. It's most likely to occur with the first infusion. After this allergic reactions tend to be milder if they do occur.
Your doctor can prescribe effective anti-sickness drugs to prevent, or greatly reduce, nausea and vomiting|. If the sickness isn't controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective.
These include a high temperature, chills, weakness, sweating, muscle aches, tiredness, dizziness and a headache. These usually settle within 2-4 hours. Your doctor can prescribe medicines to help.
This may happen during or after the infusion. Your blood pressure will be monitored during the infusion and for a while afterwards.
Mylotarg can reduce the number of white blood cells produced by the bone marrow, making you more prone to infection|.
You'll have a blood test before having more treatment to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (blood count) is still low.
Mylotarg can reduce the production of platelets, which help the blood clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin.
You may become anaemic while having treatment with Mylotarg. This may make you feel tired| and breathless. Tell your doctor or nurse if you have these symptoms.
Your mouth may become sore or dry|, or you may notice small ulcers. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help reduce the risk of this happening. Tell your doctor or nurse if you have any mouth problems, as they can prescribe special mouthwashes and medicine to prevent or clear mouth infections.
You may notice that food tastes different. Normal taste usually comes back after treatment finishes.
Mylotarg may cause changes in the way your liver works. Your doctor will monitor this closely by taking samples of your blood to check your liver is working properly. Let your doctor know if you develop pain in your right side.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects, even it they're not mentioned above.
Some medicines can be harmful to take when you're having this kind of treatment. Let your doctor know about any medications you're taking, including non-prescribed drugs such as complementary therapies| and herbal drugs.
Your ability to become pregnant or father a child may be affected by this treatment. It is important to discuss fertility| with your doctor before starting treatment.
It's not advisable to become pregnant or father a child while having Mylotarg, as it may harm the developing baby. It’s important to use effective contraception while having this drug, and for at least a few months afterwards. You can discuss this with your doctor.
It’s not known whether biological therapies can be present in semen or vaginal fluids. To protect your partner it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after treatment.
This section has been compiled using information from a number of reliable sources including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.