Caring for the Patient During Treatment
How to take care of the patient during Campath treatments
To be an active partner in the healthcare of your friend or loved one during treatments,
you should talk to the doctor or nurse to learn more about B-CLL and Campath. You
can help with treatment by reminding the patient of the following important tips
for self-care:
- Make sure that premedications are taken exactly as directed, both during and after
Campath therapy, to help prevent infections
- Ask the doctor before any other medications are taken, including over-the-counter
medications such as aspirin
- Because platelets may be temporarily
reduced, your friend or loved one should avoid excess bleeding from small cuts by
using an electric razor and a soft toothbrush
- Avoid contact sports and activities that could lead to injury
- Avoid any immunization with live viral vaccines while on Campath therapy. The safety
of live viral vaccines with Campath has not been studied
- Handwashing should be done often, since it's a simple but effective way to help
reduce the risk of infection
- Avoid people with coughs, colds, or other contagious infections
- Get plenty of rest, drink lots of water, and eat healthy foods. It is best to avoid
eating the skin of fresh fruits and vegetables, and to avoid unpasteurized milk,
certain cheeses (ask the doctor), and undercooked meat or poultry
- Record treatments, medications, and any side effects in the Campath Treatment Diary—a
great place for you and/or your friend or loved one to take notes during doctor
visits
- Schedule regular follow-up visits with the doctor as he or she recommends, and comply
with his or her requests for lab work
- Talk to the doctor and nurse before, during, and after treatments. Ask questions
and discuss your concerns. Tell them about any new symptoms or problems
Other things you can do to help your friend or loved one
Learning to live with cancer means learning many new things about the disease, treatment,
and changes in daily life. Family members and/or caregivers can help patients by
listening, helping with household chores, accompanying them on doctor visits, and
just spending time with them doing things that all of you enjoy.
WARNING: 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.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For important risk and use information, please see full Prescribing Information (PDF).
