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利妥昔单抗快速给药:恶性和良性血液病60分钟输注的安全性

Rapid rituximab administration: Safety of 60-minute infusions in malignant and benign haematological disease.

作者信息

Whiting Rebecca, Misko Jeanie, McGuire Matthew, Fox Emma

机构信息

Pharmacy Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.

出版信息

J Oncol Pharm Pract. 2025 Jul;31(5):780-784. doi: 10.1177/10781552241260863. Epub 2024 Jun 7.

DOI:10.1177/10781552241260863
PMID:38847136
Abstract

IntroductionRituximab is a chimeric monoclonal antibody used to treat a range of malignant and benign haematological conditions. To minimise the risk of infusion-related toxicity, initial infusions are administered slowly over 4-6 h. In the absence of significant reactions, subsequent doses are often administered over an off-label rate of 90 min. In response to emergent data, our site adopted the use of rapid 60-min infusions for third and subsequent doses. This study aimed to review the safety and ongoing feasibility of 60-min rituximab infusions following institutional practice change.MethodsPharmacy dispensing records were used to identify all rituximab infusions dispensed under the direction of a haematologist between 1 January 2023 and 30 June 2023. Electronic medical records were reviewed retrospectively to characterise the incidence of infusion reactions.ResultsEight-two patients received a total of 262 rituximab infusions, including 54 patients who received a total of 113 rapid 60-min infusions. No infusion-related reactions were observed with 60-min administration. Five patients who experienced grade 1-2 infusion reactions with their first or second dose of rituximab safely received 60-min infusions for third and subsequent doses without additional premedication. Indications for treatment included non-Hodgkin's lymphoma (76.99%), non-malignant disease states (17.70%), chronic lymphocytic leukaemia (3.54%) and post-transplant lymphoproliferative disorder (1.77%).ConclusionIn the absence of severe reactions to initial and second doses, administration of rituximab over 60 min is well tolerated in patients with malignant and benign haematological disease.

摘要

引言

利妥昔单抗是一种嵌合单克隆抗体,用于治疗一系列恶性和良性血液系统疾病。为将输液相关毒性风险降至最低,初始输液需在4 - 6小时内缓慢给药。若未出现明显反应,后续剂量通常以非标签规定的90分钟速度给药。鉴于新出现的数据,我们机构采用了60分钟快速输注的方式用于第三剂及后续剂量。本研究旨在回顾机构实践改变后60分钟输注利妥昔单抗的安全性及持续可行性。

方法

利用药房配药记录确定2023年1月1日至2023年6月30日期间在血液科医生指导下配药的所有利妥昔单抗输注情况。回顾电子病历以确定输液反应的发生率。

结果

82例患者共接受了262次利妥昔单抗输注,其中54例患者共接受了113次60分钟的快速输注。60分钟给药未观察到输液相关反应。5例在首次或第二次使用利妥昔单抗时出现1 - 2级输液反应的患者,在第三剂及后续剂量时安全接受了60分钟输注,且无需额外的预处理。治疗适应证包括非霍奇金淋巴瘤(76.99%)、非恶性疾病状态(17.70%)、慢性淋巴细胞白血病(3.54%)和移植后淋巴细胞增生性疾病(1.77%)。

结论

对于恶性和良性血液系统疾病患者,在对初始剂量和第二剂未出现严重反应的情况下,60分钟输注利妥昔单抗耐受性良好。

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