Considerations During Treatment
Tips for your treatment
To be active partners in your healthcare during treatments, you and your caregiver
should talk to your doctor or nurse to learn more about B-CLL and Campath. Here's
how you can help with your treatments:
- Take your premedications exactly as directed, both during and after Campath therapy,
to help prevent infections
- Ask your doctor before taking any other medications, including over-the-counter
medications such as aspirin
- Because your platelets may
be temporarily reduced, 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 or recently
treated with Campath. The safety of live viral vaccines with Campath has not been
studied
- Male and female patients with reproductive potential should use effective contraception
during treatment and for at least 6 months after Campath therapy
- Wash your hands often—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. Avoid eating the
skin of fresh fruits and vegetables, and avoid unpasteurized milk, certain cheeses
(ask your doctor), and undercooked meat or poultry
- Record your treatments, medications, and any side effects in the Campath Patient Diary—a great place for you or your caregiver
to take notes during doctor visits, too
- Schedule regular follow-up visits with your doctor as he or she recommends, and
comply with his or her requests for lab work
- Talk to your doctor or nurse before, during, and after your treatments. Ask questions
and discuss your concerns. Tell them about any new symptoms or problems
What your family and/or caregiver can do to help you
Learning to live with cancer means learning many new things about the disease, treatment,
and changes in your life. Family members and/or caregivers can help by listening,
helping with household chores, accompanying you on doctor visits, and just spending
time with you, 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).
