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Campath(卡帕什/坎帕斯,alemtuzumab,欧洲商品名:MabCampath)
2013-10-29 22:18:03 来源: 作者: 【 】 浏览:4078次 评论:0

英文药名:Campath(alemtuzumab)Injection for intravenous use

中文药名:阿仑单抗注射液(别名:坎帕斯)
药品介绍
Campath(MabCampath)—人源化单克隆抗体

Campath(欧洲商品名:MabCampath)是第一个对烷化剂或福达华治疗无效的患者仍具有显着疗效的药物。
根据一项国际II期临床研究结果显示,经其它药物治疗复发或难治的CLL患者用Campath治疗后可使其生存期显着延长1倍以上。
目前,有关专家正致力于研究该药的新用法及联合用药,如研究与福达华等联合应用的疗效。
Campath是CD52抗体,可与表面携带CD52抗原的细胞相结合从而启动细胞破坏过程。通过这一方式,Campath可以清除外周血、骨髓及其它累及器官的淋巴细胞。由于T淋巴细胞同样携带CD52抗原,Campath已被成功地应用于前T细胞性白血病(T-PLL)及外周T细胞淋巴瘤的治疗。作为对福达华的补充,Campath在非清髓性移植中也发挥着重要作用。
目前,已有越来越多的肿瘤专家在早期治疗中选择Campath。
▲MabCampath为第一及现时唯一一种被美国药物及食物管理局准许使用在B细胞型 CLL 的新的药物。
▲MabCampath是一种单克隆抗体,能有效对化疗没有效用的病人产生疗效。
▲MabCampath的原理是针对CD52抗原,这种抗原主要分布在B及T细胞的表面。
▲MabCampath由于是一种抗体,会在淋巴细胞表面与CD 52抗原结合,并会引导身体的免疫系统破坏及吞噬在血液及骨髓结合后的细胞。
临床应用规程:
1.用药前检测血常规、肝肾功能、血压、心电图、免疫功能。
2.静脉输液30分钟前予以苯海拉明50mg和对乙酰氨基酚650mg预防和减轻输液反应。如果出现严重输液反应,予以氢化可的松200mg.
3.用药前予以磺胺类药物和法昔洛韦及类似药物预防感染,直至停药后2个月或者CD4+细胞达到200000000/l以上。
4.每周检查外周血全血细胞计数,如果出现中性粒细胞减少、血小板减少则需增加检查频次。定基检测CD4+细胞直至达到200000000/l以上。
5.首次出现ANC<250000000/l以上,和/或血小板≤25000000000/L.则需要停药,直至ANC≥500000000/L.和血小板≥50000000000/L。重新用药时,停药时间在7天之内者,剂量同停药前;如停药时间超过7天,则从3mg起用,渐渐加量至10mg,30mg。
6.如果第二次出现ANC<250000000/L,和/或血小板≤25000000000/L,则需要停药,直至ANC≥500000000/L.和血小板≥50000000000/L。重新用药时,停药时间在7天之内者,剂量为10mg/d;如停药时间超过7天,则从3mg/d起用,并只能加量至10mg/d.
7.如果第三次出现ANC<250000000/L,和/或血小板≤25000000000/L,则永久停药。
8.如果患者用药前ANC<500000000/L,和/或血小板≤25000000000/L,则于ANC和/或血小板减少至用药前50%以下时停药。在ANC和/或血小板调高至用药前水平时,重新开始用药。如果停药时间超过7天,则从3mg起用,渐渐加量至10mg/30mg.
9.使用时100ml0.9%无菌生理盐水或者5%葡萄糖稀释,轻轻颠倒混匀。丢掉用过的注射器和剩余药品。每次输液持续时间2小时以上。
贮存:
原药2-8℃(36-46℃)避光保存,严禁冻存。稀释后室温(15-30℃)避光保存,8小时内使用。
完整说明书附件:http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=14130

Campath is indicated as a single agent for the treatment of B-cell chronic lymphocytic leukemia (B-CLL).
Important safety informationWARNING: CYTOPENIAS, INFUSION REACTIONS, and INFECTIONS Cytopenias: Serious, including fatal, pancytopenia/marrow hypoplasia, autoimmune idiopathic thrombocytopenia, and autoimmune hemolytic anemia can occur in patients receiving Campath. Single doses of Campath greater than 30 mg or cumulative doses greater than 90 mg per week increase the incidence of pancytopenia.
Infusion Reactions: Campath administration can result in serious, including fatal, infusion reactions. Carefully monitor patients during infusions and withhold Campath for Grade 3 or 4 infusion reactions. Gradually escalate Campath to the recommended dose at the initiation of therapy and after interruption of therapy for 7 or more days.
Infections: Serious, including fatal, bacterial, viral, fungal, and protozoan infections can occur in patients receiving Campath. Administer prophylaxis against Pneumocystis jiroveci pneumonia (PCP) and herpes virus infections.
In clinical trials, the frequency of infusion reactions was highest in the first week of treatment. The following serious, including fatal, infusion reactions have been identified in post-marketing reports: syncope, pulmonary infiltrates, acute respiratory distress syndrome (ARDS), respiratory arrest, cardiac arrhythmias, myocardial infarction, acute cardiac insufficiency, cardiac arrest, angioedema, and anaphylactoid shock.
Prolonged myelosuppression have been reported in patients receiving Campath. Campath treatment results in severe and prolonged lymphopenia with a concomitant increased incidence of opportunistic infections. Assess CD4+ counts after treatment until recovery to ≥ 200 cells/µL. Obtain complete blood counts (CBC) at weekly intervals during Campath therapy and more frequently if worsening anemia, neutropenia, or thrombocytopenia occurs. Withhold Campath for severe cytopenias (except lymphopenia). Discontinue for autoimmune cytopenias or recurrent/persistent severe cytopenias (except lymphopenia).
Administer only irradiated blood products to avoid transfusion associated Graft versus Host Disease (TAGVHD), unless emergent circumstances dictate immediate transfusion.
Routinely monitor patients for CMV infection during Campath treatment and for at least 2 months following completion of treatment. Withhold Campath for serious infections and during antiviral treatment for CMV infection or confirmed CMV viremia. Initiate therapeutic ganciclovir (or equivalent) for CMV infection or confirmed CMV viremia.
Do not administer live viral vaccines to patients who have recently received Campath.
The most common adverse reactions (≥ 10%) were infusion reactions, cytopenias, cytomegalovirus (CMV) and other infections, nausea, emesis, diarrhea, and insomnia.

Package Label–Principal Display Panel–1-Pack Carton
1 Single-Use 1 mL Vial
Campath
alemtuzumab
For Intravenous Use Only
30 mg/mL
- 30 mg/mL
- 1 vial
- Injection
30 mg/mL
No US Standard of Potency
Must be further diluted prior to IV administration
Single-Use Vial, Discard Unused Portion
See package insert for full prescribing information
Sterile
Rx Only
Note: Concentration change to 30 mg/mL
See revised insert for new instructions for preparation and administration.
Package Label – Principal Display Panel – 3-Pack Carton
NDC 58468-0357-3
3 Single-Use 1 mL Vial
Campath
alemtuzumab
For Intravenous Use Only
30 mg/mL
- 30 mg/mL
- 3 vials
- Injection
30 mg/mL
No US Standard of Potency
Must be further diluted prior to IV administration
Single-Use Vial, Discard Unused Portion
See package insert for full prescribing information
Sterile
Rx Only
Note: Concentration change to 30 mg/mL
See revised insert for new instructions for preparation and administration.
【药品名称】
商品名:Mabcampath
通用名:Campath
中文名:坎帕斯®(阿仑单抗)
供静脉滴注用注射液
美国首次批准时间:2001年
警告:血细胞减少,输液反应,感染
请参阅完整处方资料完整的黑框警告。
严重,包括致命的,血细胞减少,输液反应,感染可发生。
限制剂量30毫克和90毫克(每周累计) (单) ;较高剂量全血细胞减少的风险增加。
逐步升级剂量,并监测患者在输液过程中。扣压治疗3或4级输液反应。
管理预防对卡氏肺囊虫肺炎(PCP)和疱疹病毒感染。
最近的重大变化
警告和注意事项
适应症及用法
坎帕斯是一种溶细胞抗体CD52导向作为单药用于治疗B细胞慢性淋巴细胞白血病( B - CLL )。
剂量与用法
管理静脉滴注2小时以上。
升级为推荐剂量为30毫克/天,每周三次,共12周。
手术前用药,口服抗组胺药和对乙酰氨基酚前药量。
剂型和规格
30毫克/ 1毫升 单次使用小瓶。
禁忌
无。
警告和注意事项
血细胞减少:
获得全血细胞计数( CBC )和血小板计数在治疗后治疗和CD4细胞计数期间每周一班,直到恢复到≥ 200个细胞/ μL。
停止自身免疫性疾病或严重的血液学不良反应。
感染:
坎帕斯引起严重的和长期的淋巴细胞减少,并增加感染的风险。如果发生严重感染,拒绝治疗,直到感染解析。
不要给予活病毒疫苗近日收到坎帕斯的患者。
不良反应
最常见的不良反应(≥ 10% ) :血细胞减少,输液反应,巨细胞病毒( CMV )和其他感染,恶心,呕吐,腹泻,失眠。

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