Retrospective Study of Infusion Reactions during Re-administration of Rituximab

Abstract

Rituximab (RIT) is a mouse-human chimeric anti-CD20 monoclonal antibody that is one of the key drugs for the treatment of CD20-positive B cell non-Hodgkin lymphoma (B-NHL). Although RIT frequently causes infusion reactions (IR) during initial administration, there have been few reports about the frequency and risk factors for IR during re-administration of RIT to patients with recurrence. In this study, we investigated the frequency of clinically relevant IR (Grade ≥ 2) that occurred during re-administration of RIT and the risk factors for such IR. Twenty patients (31％) developed IR (Grade ≥ 2). These reactions commonly occurred at an infusion rate of 100 mg/hr, but some patients developed IR after the completion of rituximab administration. In addition, the incidence of IR during re-administration of RIT was significantly higher among patients who had developed IR at the time of initial administration [Odds ratio 4.74 (95％ CI 1.28 - 17.5, P = 0.012)]. When patients receive re-administration of RIT, it is necessary to pay careful attention to IR in the same way as at the time of initial administration. In particular, the re-administration of rituximab to patients at high risk of developing IR should be performed carefully, including inpatient management.