Zevalin infusion contains Yttrium-90 radiolabelled ibritumomab, which is a type of medicine known as a radiolabelled monclonal antibody. This means that it is a monclonal antibody that has been combined with a radioactive substance. It is used to treat a type of cancer called non-Hodgkins lymphoma.
Lymphomas are cancers involving white blood cells called lymphocytes. Cancer occurs when these lymphocytes, for some reason, begin to multiply in an uncontrolled way. This can cause a lump or tumour in the lymph nodes. Lymphocytes are normally involved in fighting infection and they travel around the lymphatic system and the bloodstream to do this. If abnormal cancerous lymphocytes travel, the cancer can spread to other lymph nodes and other areas of the body.
Zevalin is used to treat non-Hodgkins lymphoma that involves a sub-group of lymphocytes called B lymphocytes. It works by targeting radiation to attack the abnormal B lymphocytes.
Ibritumomab works in a similar way to the natural antibodies produced by our immune system. Our natural antibodies recognise foreign invaders and bind to them, helping our immune systems to attack them and protect us from infections. Monoclonal antibodies like ibritumomab are made in laboratories and are designed to recognise particular proteins in a similar way.
Ibritumomab specifically recognises and binds to a protein called CD20, which is found on the surface of cancerous B lymphocyte cells. The ibritumomab is combined with a radioisotope called Yttrium-90 or Y-90. This produces radiation that is strong enough to destroy cancer cells. When the ibritumomab binds to the cancerous B cells, radiation energy from the Y-90 is released that damages or kills the B cell.
Unfortunately ibritumomab can also bind to healthy B cells, because these also carry the CD20 protein. This can lead to healthy cells being damaged by the radiation. For this reason, pre-treatment is given with a similar medicine called rituximab (Mabthera). Rituximab is another monoclonal antibody that recognises and binds to the CD20 protein on B cells. However, it does not carry radiation; it simply causes the immune system to attack the B cells.
Rituximab is given on the first day of treatment to reduce the numbers of normal healthy B cells and prevent them being damaged by the Zevalin radiation. About a week later, another dose of rituximab is given, followed within four hours by Zevalin given by a drip into a vein (intravenous infusion). This takes about ten minutes. The Zevalin drip is a one-off treatment for non-Hodgkins lymphoma that has not responded to, or has come back after treatment with rituximab.
The body quickly replaces any normal healthy white blood cells that have been damaged by the treatment.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
It is important to tell your doctor if you are taking any other medicines, including over-the-counter and herbal medicines, before you have treatment with this medicine. Similarly, always seek advice from your doctor or pharmacist before taking any new medicines during and after treatment with this medicine, so they can check that the combination is safe.
As this medicine attacks your B cells, which are part of your immune system, it may make it hard for your body to produce antibodies in response to vaccinations. This means that vaccines may potentially be less effective if given during treatment, and live vaccines may cause serious infections. For this reason, if you need to have any vaccinations, these should preferably be completed a few weeks before your treatment.
There are currently no other medicines available in the UK that contain radiolabelled ibritumomab as the active ingredient.