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Anti-CD22 antibody-drug conjugate

Inotuzumab ozogamicin (Specialist drug)

Brand names: Besponsa

Inotuzumab ozogamicin is an anti-CD22 antibody-drug conjugate used as a specialist treatment for relapsed or refractory CD22-positive B-cell acute lymphoblastic leukaemia. It is given by intravenous infusion under haemato-oncology supervision.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

The antibody targets CD22 on B-lineage leukaemic cells and delivers the cytotoxic agent calicheamicin intracellularly, causing DNA double-strand breaks and cell death.

Prescribing in practice

  • Hepatotoxicity, including potentially fatal veno-occlusive disease (sinusoidal obstruction syndrome), is a major risk, particularly around haematopoietic stem cell transplant.
  • Premedication and tumour lysis precautions are used, and infusion reactions can occur.
  • Prolongation of the QT interval and myelosuppression require attention and supportive management.

Monitoring

Monitor liver function tests closely, full blood count, and for signs of veno-occlusive disease and infection throughout treatment.

Counselling the patient

  • Report yellowing of the skin or eyes, abdominal swelling or right-sided abdominal pain promptly.
  • Report fever, bruising or bleeding, as blood counts can fall.
  • Effective contraception is required during and after treatment as advised by the team.

Evidence & guidelines

The INO-VATE ALL trial showed higher remission rates with inotuzumab ozogamicin than standard chemotherapy in relapsed or refractory B-cell ALL.

Reference: NICE TA541; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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