Infusion Reactions

Vogel, Wendy H

doi:10.1188/10.cjon.e10-e21

Cited by 169 publications

(85 citation statements)

References 43 publications

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“…Additional risk factors for IRRs related with rituximab are certain types of lymphoma, such as CLL and mantle cell lymphoma, and a high number of circulating lymphocytes [18,23]. In our study, 87.5% of the patients with CLL experienced IRRs, but patients with mantle cell lymphoma did not show any difference in the incidence of IRR from patients with other lymphomas.…”

Section: Discussionmentioning

confidence: 44%

The Incidence and Risk Factors of Infusion-Related Reactions to Rituximab for Treating B Cell Malignancies in a Single Tertiary Hospital

Jung

Kang²,

Lee

et al. 2014

Oncology

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Background: Rituximab is a chimeric anti-CD20 human/mouse monoclonal antibody. As its usage has increased, there have been growing concerns about rituximab-related infusion-related reactions (IRRs). Objective: The aim of this study is to verify the clinical features and risk factors of IRRs by rituximab, and to help establish clinical guidelines for their prevention. Methods: We reviewed electronic medical records of all the adult patients who were prescribed rituximab from January 2005 to July 2010 for B cell malignancy at Seoul National University Hospital. Results: A total of 389 cases of IRRs by rituximab (12.5% of a total of 3,104 infusions) were identified in 281 patients (49.4% of a total of 568 patients). IRRs most frequently occurred during the first infusion (40.5%) and abruptly decreased in subsequent infusions to rates of 3-8% (p < 0.001). The incidence of IRRs in patients premedicated with corticosteroid for their first infusion was significantly lower when compared to patients not pretreated with corticosteroid prior to rituximab infusion (8.3 vs. 41.2%, p = 0.017). Conclusion: Almost half of all patients in the study experienced IRRs at least once during their scheduled rituximab treatment. Premedication with corticosteroid can be recommended in patients with high risk of IRR in the first infusion.

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Section: Discussionmentioning

confidence: 44%

The Incidence and Risk Factors of Infusion-Related Reactions to Rituximab for Treating B Cell Malignancies in a Single Tertiary Hospital

Jung

Kang²,

Lee

et al. 2014

Oncology

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“…Treatment with ICIs was associated with a higher incidence of any‐grade and grade 3 to 4 irAEs (ie, rash, aspartate aminotransferase increase, hypothyroidism, colitis, and pneumonitis) compared with non‐ICI regimens 31. The incidence of IRRs and hypersensitivity reactions occurring with avelumab and other ICIs was similar to or less than the incidence reported with other systemic and targeted treatments, including commonly used taxane‐based chemotherapy 32. Overall, treatment with anti–PD‐L1/PD‐1 antibodies was better tolerated than chemotherapy; was associated with a lower incidence of TRAEs; and, although associated with an increased incidence of irAEs, offered a favorable risk‐benefit profile.…”

Section: Discussionmentioning

confidence: 71%

Safety profile of avelumab in patients with advanced solid tumors: A pooled analysis of data from the phase 1 JAVELIN solid tumor and phase 2 JAVELIN Merkel 200 clinical trials

Kelly

Infante

Taylor

et al. 2018

Cancer

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BACKGROUNDAntibodies targeting the programmed death‐ligand 1 (PD‐L1)/programmed cell death protein 1 (PD‐1) checkpoint may cause adverse events (AEs) that are linked to the mechanism of action of this therapeutic class and unique from those observed with conventional chemotherapy.METHODSPatients with advanced solid tumors who were enrolled in the phase 1 JAVELIN Solid Tumor (1650 patients) and phase 2 JAVELIN Merkel 200 (88 patients) trials received avelumab, a human anti–PD‐L1 IgG1 antibody at a dose of 10 mg/kg every 2 weeks. Treatment‐related AEs (TRAEs) were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0). In post hoc analyses, immune‐related AEs (irAEs) were identified via an expanded AE list and medical review, and infusion‐related reactions (IRRs) occurring ≤2 days after infusion and symptoms occurring ≤1 day after infusion and resolving ≤2 days after onset were identified based on prespecified Medical Dictionary for Regulatory Activities (MedDRA) terms.RESULTSOf the 1738 patients analyzed, grade ≥3 TRAEs occurred in 177 (10.2%); the most common were fatigue (17 patients; 1.0%) and IRR (10 patients; 0.6%). TRAEs led to discontinuation in 107 patients (6.2%) and death in 4 patients (0.2%). Grade ≥3 irAEs occurred in 39 patients (2.2%) and led to discontinuation in 34 patients (2.0%). IRRs or related symptoms occurred in 439 patients (25.3%; grade 3 in 0.5% [9 patients] and grade 4 in 0.2% [3 patients]). An IRR occurred at the time of first infusion in 79.5% of 439 patients who had an IRR, within the first 4 doses in 98.6% of 439 patients who had an IRR, and led to discontinuation in 35 patients (2.0%).CONCLUSIONSAvelumab generally was found to be well tolerated and to have a manageable safety profile. A minority of patients experienced grade ≥3 TRAEs or irAEs, and discontinuation was uncommon. IRRs occurred mainly at the time of first infusion, and repeated events were infrequent. Cancer 2018;124:2010‐7. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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“…The production of antibodies such as ANCA is thus suppressed by suppressing the differentiation of B cells into plasma cells. RTX is generally administered to patients as multiple infusions, and infusion-related side effects such as fever, chills, rash, pruritis, nausea, headache, hypotension, and bronchospasm are well known; they usually occur within a few hours of the initiation of the ﬁrst infusion (4). As hematological abnormalities due to RTX, neutropenia, thrombocytopenia and anemia have been described, which generally occur during the first 10-14 days after the infusion (5).…”

Section: Introductionmentioning

confidence: 99%

Rituximab-induced Acute Thrombocytopenia in Granulomatosis with Polyangiitis

et al. 2018

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A 72-year-old Japanese woman diagnosed with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis was admitted to our hospital with hearing loss, temporal pain, and sudden blindness. We finally diagnosed recurrent granulomatosis with polyangiitis and initiated methyl-prednisolone pulse therapy (1,000 mg) followed by prednisolone (30 mg/day) and rituximab (RTX). After the third RTX administration, she developed bloody stools along with acute thrombocytopenia and low complement levels. We diagnosed rituximab-induced acute thrombocytopenia (RIAT), and her platelet counts spontaneously recovered. This case suggests that after RTX therapy RIAT may sometimes cause severe thrombocytopenia, and that monitoring the complements may be useful for making an early diagnosis of RIAT.

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Infusion Reactions

Cited by 169 publications

References 43 publications

The Incidence and Risk Factors of Infusion-Related Reactions to Rituximab for Treating B Cell Malignancies in a Single Tertiary Hospital

The Incidence and Risk Factors of Infusion-Related Reactions to Rituximab for Treating B Cell Malignancies in a Single Tertiary Hospital

Safety profile of avelumab in patients with advanced solid tumors: A pooled analysis of data from the phase 1 JAVELIN solid tumor and phase 2 JAVELIN Merkel 200 clinical trials

Rituximab-induced Acute Thrombocytopenia in Granulomatosis with Polyangiitis

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