TY - JOUR
T1 - Rituximab toxicity in patients with peripheral blood malignant B-cell lymphocytosis
AU - Kanelli, Stamatina
AU - Ansell, Stephen M.
AU - Habermann, Thomas M.
AU - Inwards, David J.
AU - Tuinstra, Nancy
AU - Witzig, Thomas E.
PY - 2001
Y1 - 2001
N2 - Infusion related adverse events (AE) with day 1 rituximab in patients with B-cell non-Hodgkin's lymphoma (NHL) are common. The purpose of this study was to evaluate the AE occurring in patients with malignant B-cell lymphocytosis who received rituximab. Patients with a ≥ 3 × 109/L absolute lymphocyte count (ALC) receiving rituximab from 1998 to 1999 or participating in a phase I study of rituximab and interleukin-12 were reviewed. The AE occurring on the day of rituximab, the treatment provided (including hospitalization), and the subsequent ALC responses were recorded. Twenty-seven patients were identified; 14 had NHL, one Waldenstrom's macroglobulinemia, and 12 patients had chronic lymphocytic leukemia. The baseline median ALC was 9.58 × 109/L (mean, 49.31; range, 3.56-380.95). All patients received rituximab as an outpatient. There were only two AE ≥ grade 3. One patient was hospitalized for 1 day for IV fluids to treat an increase in creatinine that occurred with tumor lysis. A second patient developed a pulmonary syndrome five days after day 1 rituximab and required mechanical ventilation, but had no long-term lung toxicity. This study demonstrates that patients with high numbers of circulating blood B-lymphocytes can usually safely receive rituximab as outpatients. Patients who experience a rapid drop in ALC should be monitored closely for tumor lysis and the pulmonary syndrome.
AB - Infusion related adverse events (AE) with day 1 rituximab in patients with B-cell non-Hodgkin's lymphoma (NHL) are common. The purpose of this study was to evaluate the AE occurring in patients with malignant B-cell lymphocytosis who received rituximab. Patients with a ≥ 3 × 109/L absolute lymphocyte count (ALC) receiving rituximab from 1998 to 1999 or participating in a phase I study of rituximab and interleukin-12 were reviewed. The AE occurring on the day of rituximab, the treatment provided (including hospitalization), and the subsequent ALC responses were recorded. Twenty-seven patients were identified; 14 had NHL, one Waldenstrom's macroglobulinemia, and 12 patients had chronic lymphocytic leukemia. The baseline median ALC was 9.58 × 109/L (mean, 49.31; range, 3.56-380.95). All patients received rituximab as an outpatient. There were only two AE ≥ grade 3. One patient was hospitalized for 1 day for IV fluids to treat an increase in creatinine that occurred with tumor lysis. A second patient developed a pulmonary syndrome five days after day 1 rituximab and required mechanical ventilation, but had no long-term lung toxicity. This study demonstrates that patients with high numbers of circulating blood B-lymphocytes can usually safely receive rituximab as outpatients. Patients who experience a rapid drop in ALC should be monitored closely for tumor lysis and the pulmonary syndrome.
KW - Chronic lymphocytic leukemia
KW - Non-Hodgkin's lymphoma
KW - Rituximab
UR - http://www.scopus.com/inward/record.url?scp=0035697071&partnerID=8YFLogxK
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U2 - 10.1080/10428190127502
DO - 10.1080/10428190127502
M3 - Article
C2 - 11911416
AN - SCOPUS:0035697071
SN - 1042-8194
VL - 42
SP - 1329
EP - 1337
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 6
ER -