3. ANTIBODIES and FUSION PROTEINS
TOXICITY
common to all:
- infusion reactions (77% of patients on rituximab)
- hypersensitivity reactions: fever, muscle aches, headaches, rashes, anaphylaxis
- infections
- esp reactivation of tuberculosis
- unknown effects on immunization, carcinogenesis, mutagenesis, impairment of fertility, pregnancy, nursing infants (human IgG is secreted in milk)
specific toxicities:
- cardiac arrhythmias
- tumour lysis syndrome
- ALEMTUZUMAB: cough, tightness in chest
- suspicion that radiolabelled antibodies (IBRITUMOMAB, TOSITUMOMAB) may be more likely to cause birth defects (this hasn't been tested!)