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How it is administered
Ofatumumab is administered as an intravenous (IV) infusion. The medication comes as a clear, colorless solution that is diluted and given through a vein by a healthcare professional in a clinic or hospital setting. It is not given as a subcutaneous injection or as a rapid IV push.
The dosing schedule depends on the specific treatment plan, but for blood cancers like B-cell Prolymphocytic Leukemia (B-PLL) and chronic lymphocytic leukemia (CLL), it is typically given in cycles. For example, the initial dose may be 300 mg on Day 1, followed by 1,000 mg on Day 8, and then 1,000 mg on Day 1 of subsequent 28-day cycles. The number of cycles and total duration of therapy may vary based on your response and your doctor's recommendations.
How it works
Ofatumumab is a type of medicine called a monoclonal antibody. It works by targeting a specific protein called CD20, which is found on the surface of certain B-cells, including cancerous B-cells in blood cancers like B-PLL and CLL.
When ofatumumab binds to the CD20 protein, it triggers the immune system to destroy these B-cells. This happens through two main processes: complement-dependent cytotoxicity (which helps break down the cell membrane) and antibody-dependent cell-mediated cytotoxicity (which recruits immune cells to attack the cancerous B-cells). By reducing the number of abnormal B-cells, ofatumumab helps control the growth and spread of the leukemia. The depletion of B-cells in the blood is a sign that the medication is working, although the exact correlation with clinical response can vary.
Common side effects
- Infusion reactions (fever, chills, rash, breathing problems, flushing, or low blood pressure)
- Neutropenia (low white blood cell count)
- Infections (including upper respiratory tract infections, pneumonia, and urinary tract infections)
- Anemia (low red blood cell count)
- Thrombocytopenia (low platelet count)
- Fatigue
- Nausea or diarrhea
- Cough or shortness of breath
- Headache
Most infusion reactions occur during or shortly after the first or second infusion. Your healthcare team will monitor you closely and may give you medicines before the infusion to help prevent or lessen these reactions.
Who Should take it
Ofatumumab is approved for use in adults with certain types of blood cancers, including chronic lymphocytic leukemia (CLL). It may be used in combination with other chemotherapy medicines or as a single agent, especially in patients who have not responded to other treatments or for whom standard therapies are not appropriate.
While there is limited direct data for B-cell Prolymphocytic Leukemia (B-PLL), ofatumumab may be considered in some cases due to its similar mechanism of action against B-cells. Your doctor will decide if ofatumumab is right for you based on your specific diagnosis, prior treatments, and overall health.
Who should not take it
Ofatumumab should not be used in patients with a known hypersensitivity to the medication or any of its components. It should also be avoided in patients with active, severe infections, especially hepatitis B virus (HBV) infection, as reactivation can occur and may be life-threatening.
Caution is advised in patients with low blood counts (cytopenias), those with a history of severe infusion reactions, or those who are pregnant or breastfeeding. Live vaccines should not be given during or soon after treatment with ofatumumab, as the immune system may be weakened.
Commonly used with
Ofatumumab is often used in combination with other chemotherapy drugs, such as chlorambucil, fludarabine, and cyclophosphamide, especially for the treatment of CLL. These combinations can help improve treatment effectiveness by attacking the cancer cells in different ways.
Your doctor may also prescribe supportive medications, such as acetaminophen, antihistamines, and corticosteroids, to reduce the risk of infusion reactions.
Commonly tested with
Ofatumumab has been tested in clinical trials with various chemotherapy agents, including chlorambucil, fludarabine, and cyclophosphamide. It has also been studied as a single agent in patients who have not responded to other treatments.
In some studies, ofatumumab has been compared to other anti-CD20 antibodies or used in extended treatment regimens to maintain remission in patients who have responded to initial therapy.
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