The Pharmaceutical Journal
Vol 275 No 7356 p9
2 July 2005

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Rapid-infusion rituximab helps meet cancer targets

Rapid infusion of rituximab (MabThera) helps hospitals to meet demands for lymphoma treatment, according to a study presented at the 9th International Conference on Malignant Lymphoma held in Lugano, Switzerland, last month.

Rituximab, in combination with cyclo-phosphamide, doxorubicin, vincristine and prednisolone (R-CHOP), is first-line therapy for aggressive non-Hodgkin’s lymphoma (NHL). Like other monoclonal antibodies, rituximab is associated with infusion-related reactions such as fever, chills and rigors. To reduce this risk, current administration guidelines recommend lengthy infusion times of five to six hours for the first infusion, and three to four hours for subsequent infusions.

Reporting the results of the study, Laurie Sehn, British Columbia Cancer Agency, Canada, explained that, although rituximab improved outcome of NHL, long infusion times increased staff workload and prevented expansion of services. The Canadian protocol retains the initial long infusion, but reduces subsequent administration times to 90 minutes. Rituximab is given on the same day as chemotherapy and rapid infusion has been well tolerated. “So far, there have been no grade III/IV adverse reactions, and there has been no increased incidence of minor reactions,” said Dr Sehn.

Rapid-infusion rituximab is now being introduced in the UK. Mike Jillings, haematology/oncology pharmacist at Queen Elizabeth Hospital, King’s Lynn, was an early advocate. “Long infusion times for rituximab mean many hours in the clinic for NHL patients, and have increased our oncology patients’ waiting times for chemotherapy,” he explained.

Mr Jillings added: “Rapid infusion will be more convenient for patients, who will be home after two to three hours compared with four to five hours with long infusion. The new infusion schedule will also help us to treat our NHL patients more quickly and to meet our targets for oncology waiting times.”