Gemtuzumab (Mylotarg ®)
Gemtuzumab ozogamacin (Mylotarg ®) is a monoclonal antibody used to treat acute myeloid leukaemia (AML) as part of a clinical research trial.
Gemtuzumab ozogamacin is a type of monoclonal antibody. It is used to treat acute myeloid leukaemia (AML) as part of a clinical research trial. It is sometimes called mylotarg ®.
Monoclonal antibodies are sometimes called targeted therapies. They work by ‘targeting’ specific proteins on the surface of cancer cells. Mylotarg targets a protein called CD33, which is found on the surface of leukaemia cells and myeloid cells (developing white blood cells). Mylotarg has two parts to it – gemtuzumab and a chemotherapy drug called ozogamicin. Gemtuzumab locks on to the CD33 protein and releases ozogamicin into the leukaemia cells to damage and kill them.
Mylotarg is used as part of clinical research trials to treat acute myeloid leukaemia (AML). You will usually have mylotarg in combination with chemotherapy drugs. At the moment in the UK it has not been approved for use outside of trials.
Your cancer doctor, nurse or clinical trials nurse can tell you more about clinical trials. You'll see your doctor regularly while you have this treatment.
Some people have a reaction to Mylotarg. Your nurse will give you paracetamol tablets before you start your treatment. They will then give you an antihistamine as an injection into a vein or as tablets. The paracetamol and antihistamine help to reduce the chance of you having a reaction. You may also have steroids to help prevent it.
The nurse will give you Mylotarg as a drip into your vein. They will usually run the drip through a pump, which will give you the treatment over a set time. Mylotarg is sensitive to light and is protected from the light when being given. Each infusion is given over about two hours. Your treatment will be given through one of the following:
A short thin tube (cannula) that the nurse puts into a vein in your arm or hand.
A fine tube that goes under the skin of your chest and into a vein close by (central line).
A fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line).
While you are having mylotarg
Some people might have side effects while they are having this treatment.
Mylotarg may cause an allergic reaction while it’s being given. The nurse will give you drugs to help prevent or reduce this. They will check you for signs of a reaction. If you have one, they will treat it quickly.
Signs of a reaction can include: flu-like symptoms (headaches, a high temperature or chills); feeling sick; a rash; feeling itchy; breathlessness; having pain in your back, tummy or chest; or feeling unwell. Tell your nurse straight away if you have any of these symptoms. Reactions can happen a few hours after treatment. If you develop any of these symptoms or feel unwell, tell your nurse straight away.
Low blood pressure
Some people's blood pressure falls while they are having Mylotarg. If you usually take medicine to lower your blood pressure, your doctor may ask you not to take it for 12 hours before having mylotarg. The nurse will check your blood pressure regularly.
Possible side effects of mylotarg
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Each person's reaction to 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.
Risk of infection
Mylotarg can reduce the number of white blood cells. This will make you more likely to get an infection. When your white blood cell counts are low, it’s called neutropenia.
Contact the hospital straight away on the contact number you’ve been given if:
your temperature goes over 37.5°C (99.5F) or over 38°C (100.4F), depending on the advice given by the hospital staff
you suddenly feel unwell, even with a normal temperature
you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
You'll have a blood test before having more treatment to make sure that your blood cells have recovered. If your blood cells are still low, your doctor may delay your treatment for a short time.
Bruising and bleeding
Mylotarg can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. Some people may need a drip to give them extra platelets.
Anaemia (low number of red blood cells)
Mylotarg can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. A low red blood count is called anaemia. This may make you feel tired and breathless. Tell your doctor or nurse if you feel like this. You may need to have a drip to give you extra red blood cells (blood transfusion).
This may happen in the first few days of your treatment. The nurses will give you anti-sickness drugs regularly. If you still feel sick, tell your nurse or doctor. They can change the anti-sickness drug to one that works better for you.
Your mouth may become sore or dry, or you may get ulcers during this treatment. Look after your mouth by gently cleaning your teeth after meals with a soft toothbrush and drinking plenty of fluids.
Tell your nurse or doctor if you have any of these problems. They can prescribe mouthwashes and medicine to prevent or clear mouth infections.
You may get a bitter or metallic taste in your mouth or find that food tastes different. This should go away when your treatment finishes. Try using herbs and spices (unless you have a sore mouth or ulcers) or strong-flavoured sauces to give your food more flavour. Sucking boiled sweets can sometimes help to get rid of a bitter or metallic taste. Your nurse can give you more advice about this.
You may have frequent or loose bowel movements. Your doctor can prescribe drugs to control diarrhoea. Let them know if it is severe or if it doesn’t get better. Make sure you drink at least 2 litres (3.5 pints) of fluids every day if you have diarrhoea.
Mylotarg may make you constipated. Drinking at least 2 litres of fluids (3.5 pints) every day will help. Try to eat more foods that contain fibre (such as fruit, vegetables and wholemeal bread) and take some regular gentle exercise.
Effects on the liver
Mylotarg may cause changes in the way your liver works. You will have regular blood tests to check how well your liver is working.
You may get pain in your joints or muscles for a few days after treatment. Tell your doctor if this happens so they can prescribe painkillers. Let them know if the pain does not get better. Try to get plenty of rest. Taking regular warm baths may help.
Tumour lysis syndrome (TLS)
Mylotarg may cause the leukaemia cells to break down very quickly. This releases uric acid (a waste product) into the blood. The kidneys usually get rid of uric acid but may not be able cope with large amounts. This can cause chemical imbalances in the blood that affect the kidneys and the heart. This is called tumour lysis syndrome (TLS).
To reduce the risk of TLS, your doctor may give you a drug called allopurinol or rasburicase. You will also be given fluid through your drip to help protect your kidneys.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they're not mentioned above.
Other information about mylotarg
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Some medicines, including those that you can buy in a shop or chemist, can be harmful to take when you're having Mylotarg. Tell your doctor about any medicines you're taking, including drugs that you can buy for yourself, complementary therapies and herbal drugs.
Mylotarg or other trial drugs may affect your fertility (being able to get pregnant or father a child). If you are worried about this, you can talk to your doctor or nurse before treatment starts.
Your doctor will advise you not to become pregnant or father a child while taking this drug. It’s important to use effective contraception during and for a few months after chemotherapy. You can talk to your doctor or nurse about this.
Women are advised not to breastfeed while taking Mylotarg and for a few months afterwards. This is in case there is any of the drug in their breast milk.
Medical and dental treatment
If you need to go into hospital for a reason not related to the cancer, tell the doctors and nurses looking after you that you’re having treatment for AML. You should tell them the name of your cancer specialist so that they can ask them for advice.
Always tell your dentist that you are having treatment.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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