%0 Journal Article
%T Infusion Rate Escalation Study of Rituximab in Patients with CD20+ B-Cell Lymphomas: A Single Institution Analysis in Japan
%A Masahiro Yokoyama
%A Yasuhito Terui
%A Kengo Takeuchi
%A Eriko Nara
%A Kenji Nakano
%A Kyoko Ueda
%A Noriko Nishimura
%A Yuko Mishima
%A Sakura Sakajiri
%A Naoko Tsuyama
%A Keiya Ozawa
%A Kiyohiko Hatake
%J ISRN Oncology
%D 2013
%R 10.1155/2013/863909
%X Background. To determine the maximum tolerable infusion rate of rituximab, and investigate the safety and feasibility of rapid infusion of rituximab for patients with CD20 positive B-cell lymphomas (CD20+NHL). Patients and Methods. 18 patients with CD20+NHL were registered. This study had six cohorts of administration rate of rituximab. The median age was 56 years (range, 38¨C79), and five of 18 patients were male. Two patients (11%) with diffuse large B-cell lymphoma were receiving R-CHOP therapy, two (11%) with indolent lymphoma were receiving R-CVP therapy, and 14 (78%) with indolent lymphoma were receiving rituximab as maintenance therapy. Results. A total of 88 cycles of rituximab was administered. Rapid infusion of rituximab was well tolerated, with only one grade 3 leukocytepenia and one grade 4 neutropenia. Four patients (22%) developed grade 1 infusion-related toxicities at the first administration of rituximab. No patient with severe drug-related events was observed. Conclusions. We determined that the maximum tolerable infusion rate of rituximab is 300£¿mL/h (under 700£¿mg/h), and confirmed that administration of over 60 minutes is safe and feasible. We recommend rapid administration of rituximab for practice setting in patients with CD20+NHL being treated with rituximab or rituximab-containing chemotherapy. (Clinical trial no. JFCR2009-1027). 1. Introduction Rituximab, a chimeric murine/human IgG kappa monoclonal antibody, has been developed against CD20+ B-cell lymphomas (CD20+NHL) [1]. Adding rituximab to chemotherapy is standard therapy for patients with CD20+ aggressive and indolent B-cell lymphomas (CD20+NHL) and, more recently, as maintenance therapy after response to induction therapy for indolent B-cell lymphoma [2¨C5]. Despite the improved outcome with the addition of rituximab to chemotherapy, its administration can be associated with infusion-related toxicities such as fever, rash, urticaria, dyspnea, bronchospasms, hypertension, hypotension, or other allergic reactions/hypersensitivities. Infusion-related reactions can occur in approximately one-fourth of patients receiving the first administration of rituximab. Recommendations to reduce the incidence of these reactions include the administration of rituximab over a prolonged period, usually 5-6 hours for the first infusion and 3-4 hours for subsequent infusions. Recently, several investigators have reported that rapid infusion of rituximab, for approximately 60¨C90 minutes, is a safe administration schedule for the patients with CD20+NHL [6¨C11]. However, it is unclear what would
%U http://www.hindawi.com/journals/isrn.oncology/2013/863909/