Oncology Drug Reference Sheet: Blinatumomab

November 27, 2019 by Kristine B. LeFebvre DNP, RN, NPD-BC, AOCN®

Blinatumomab received accelerated approval from the U.S. Food and Drug Administration (FDA) in 2014 for the treatment of B-cell precursor acute lymphoblastic leukemia (ALL). The drug’s unique administration procedures have prompted nurses to evaluate their practice for safety.


Monoclonal antibody (bispecific) targeting and binding with CD-19 on precursor B cells and with CD3 on the surface of T cells.


Adults and children with B-cell precursor ALL in first or second complete remission with at least 0.1% minimal residual disease (MRD) or those with relapsed or refractory B-cell precursor ALL.  


Fixed dose for patients weighing at least 45 kg; adjusted for smaller patients based on body surface area. Toxicities require dose adjustments. 


Premedicate with dexamethasone. Infuse over 24 or 48 hours via a dedicated IV line primed with the drug. Calculate dose carefully to account for priming the IV line to ensure a full dose. Do not flush the IV line after infusion. Discard tubing with any remaining solution. Use IV tubing containing a sterile, nonpyrogenic, low protein-binding, 0.2 micron inline filter. The dose may be prepared in bacteriostatic 0.9% sodium chloride injection and infused over seven days in patients weighing more than 22 kg without an inline filter. Administer as a continuous infusion at a constant flow rate using a nonelastometric infusion pump that is programmable, lockable, and alarmed.

Adverse Reactions

Nursing Considerations

Patient Education 

Gero-Oncology Considerations

Patients older than 65 experienced no change in efficacy but had increased risk of infections and neurologic toxicities.

Safe Handling

May cause fetal harm when administered to pregnant women. No carcinogenicity or genotoxicity studies have been conducted.

Patient Assistance Program

Find copay information and resources at amgenassist360.com (https://www.amgenassist360.com/).

Copyright © 2019 by the Oncology Nursing Society. User has permission to print one copy for personal or unit-based educational use. Contact pubpermissions@ons.org for quantity reprints.