Whiting Rebecca, Misko Jeanie, McGuire Matthew, Fox Emma
Pharmacy Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
J Oncol Pharm Pract. 2025 Jul;31(5):780-784. doi: 10.1177/10781552241260863. Epub 2024 Jun 7.
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.
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。