Plasmapheresis therapy for rare but potentially fatal reaction to rituximab

Deborah Hastings, Bhavesh Patel, Antonio Sergio Torioni, Farouk Mookadam, Jeffrey Betcher, Adyr Moss, Raymond Heilman, Marek Mazur, Khaled Hamawi, David Mulligan, Kunam Reddy, Kristin Mekeel, Harini Chakkera

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Rituximab (Rituxan), a genetically engineered chimeric murine and human IgG1 monoclonal antibody directed against CD20 antigen, is an emerging drug used for a wide spectrum of disease processes and found to be relatively safe. We report a near-fatal reaction to rituximab, which started 30 min after infusion and worsened over 24 to 48 h, resulting in hemodynamic and respiratory compromise that necessitated both intubation and high-dose vasopressors. Subsequent treatment with plasmapheresis helped stabilize and improve the patient's clinical condition, and the patient was discharged home on hospital day 5. There is no specific treatment for these severe and sometimes fatal reactions except supportive care with plasmapheresis. With the increased use of rituximab therapy in the medical management of numerous diseases, those in the medical community need to be cognizant of the rare fatal or near-fatal infusion reaction and the benefit that may accrue from plasmapheresis therapy.

Original languageEnglish (US)
Pages (from-to)28-31
Number of pages4
JournalJournal of Clinical Apheresis
Volume24
Issue number1
DOIs
StatePublished - Apr 2 2009

Keywords

  • Antibodies
  • Antigens
  • CD20
  • Hematological neoplasms
  • Monoclonal

ASJC Scopus subject areas

  • Hematology

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