Marqibo is a cancer medication that interferes with the growth of cancer cells and slows their spread in the body.

Marqibo is used to treat a type of blood cancer called Philadelphia chromosome negative acute lymphoblastic leukemia (ALL). It is usually given after at least two other cancer medications have been tried without success.

Marqibo is given after at least two other cancer treatments did not work or have stopped working.

You should not Marqibo if you have Charcot-Marie-Tooth syndrome or other conditions that cause damage to myelin (protective covering of the nerves in your brain and spinal cord).

Marqibo is given as an infusion into a vein, usually once a week. A healthcare provider will give you this injection.

Marqibo must be given slowly, and the infusion can take at least 1 hour to complete.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when Marqibo is injected.

Marqibo can cause severe constipation. You may be given medication to prevent constipation while you are receiving Marqibo. Use all medications as directed by your doctor.

Avoid constipation by a eating fruits, vegetables, and foods high in fiber. Drink plenty of fluids.

Marqibo can lower your blood cell counts. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.

Usual Adult Dose of Marqibo for Malignant Disease:

Manufacturer suggested dose: 1.4 mg/m2 IV over one minute once a week

Comments:
-This dose is the manufacturer recommendation. It is only a guideline. Institutional protocol should be consulted.
-The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Use: Acute leukemia (this drug has also been shown to be useful in combination with other oncolytic agents in Hodgkin's disease, non-Hodgkin's malignant lymphomas, rhabdomyosarcoma, neuroblastoma, Wilms' tumor)

Usual Adult Dose of Marqibo for Solid Tumors:

Manufacturer suggested dose: 1.4 mg/m2 IV over one minute once a week

Comments:
-This dose is the manufacturer recommendation. It is only a guideline. Institutional protocol should be consulted.
-The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Use: Acute leukemia (this drug has also been shown to be useful in combination with other oncolytic agents in Hodgkin's disease, non-Hodgkin's malignant lymphomas, rhabdomyosarcoma, neuroblastoma, Wilms' tumor)

Usual Pediatric Dose of Marqibo for Malignant Disease:

Less than 18 years and less than or equal to 10 kg:
-Initial dose: 0.05 mg/kg IV over one minute once a week
-Maximum dose: 2 mg/m2 IV over one minute once a week

Less than 18 years and greater than 10 kg: 1 to 2 mg/m2 IV over one minute once a week

Comments:
-This dose is the manufacturer recommendation. It is only a guideline. Institutional protocol should be consulted.
-The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Use: Acute leukemia (this drug has also been shown to be useful in combination with other oncolytic agents in Hodgkin's disease, non-Hodgkin's malignant lymphomas, rhabdomyosarcoma, neuroblastoma, Wilms' tumor)

Usual Pediatric Dose of Marqibo for Solid Tumors:

Less than 18 years and less than or equal to 10 kg:
-Initial dose: 0.05 mg/kg IV over one minute once a week
-Maximum dose: 2 mg/m2 IV over one minute once a week

Less than 18 years and greater than 10 kg: 1 to 2 mg/m2 IV over one minute once a week

Comments:
-This dose is the manufacturer recommendation. It is only a guideline. Institutional protocol should be consulted.
-The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Use: Acute leukemia (this drug has also been shown to be useful in combination with other oncolytic agents in Hodgkin's disease, non-Hodgkin's malignant lymphomas, rhabdomyosarcoma, neuroblastoma, Wilms' tumor)

You should not use Marqibo if you are allergic to vincristine liposome, or if you have Charcot-Marie-Tooth syndrome or other conditions that cause damage to myelin (protective covering of the nerves in your brain and spinal cord).

To make sure Marqibo is safe for you, tell your doctor if you have:

• liver disease;

• a nerve-muscle disorder such as myasthenia gravis, ALS (Lou Gehrig's disease), multiple sclerosis, or muscular dystrophy;

• a bowel obstruction called paralytic ileus; or

• peripheral vascular disease such as Raynaud's syndrome.

Vincristine liposome may harm an unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.

You should not breastfeed while using Marqibo. If you use a breast pump during this time, throw out any milk you collect. Do not feed it to your baby. Follow your doctor's instructions about when you can start breastfeeding again after your treatment ends.

Call your doctor for instructions if you miss an appointment for your Marqibo injection.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid driving or hazardous activity until you know how Marqibo will affect you. Your reactions could be impaired.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Get emergency medical help if you have signs of an allergic reaction to Marqibo: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• severe constipation, stomach pain, bloating;

• severe ongoing nausea, vomiting, or diarrhea;

• numbness, tingling, weakness, or burning pain in your hands or feet;

• severe tiredness;

• low blood cell counts - fever, chills, cough, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath; or

• signs of tumor cell breakdown - tiredness, weakness, muscle cramps, nausea, vomiting, diarrhea, fast or slow heart rate, tingling in your hands and feet or around your mouth.

Common Marqibo side effects may include:

• fever, low blood cell counts;

• tiredness;

• numbness, tingling;

• diarrhea, constipation,

• nausea, loss of appetite; or

• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your current medicines. Many drugs can interact with Marqibo, especially:

• nefazodone;

• St. John's wort;

• an antibiotic - clarithromycin, rifabutin, rifampin, rifapentine, telithromycin;

• antifungal medicine - itraconazole, ketoconazole;

• antiviral medicine to treat hepatitis C or HIV/AIDS - efavirenz, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir, telaprevir, tipranavir;

• cancer medicine - apalutamide, enzalutamide, mitotane;

• heart or blood pressure medication - amiodarone, dronedarone, quinidine, ranolazine, verapamil;

• medicine to prevent organ transplant rejection - cyclosporine, tacrolimus;

• seizure medicine - carbamazepine, oxcarbazepine, phenytoin, primidone; or

• steroid medicine - dexamethasone, prednisone.

This list is not complete and many other drugs may interact with vincristine liposome. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.