Rapid Rituximab Administration Safe for Primary CNS Lymphoma

Rapid administration of rituximab over 90 minutes was safe and feasible for patients with primary central nervous system (CNS) lymphoma, according to a study presented at the 21^st Annual Scientific Meeting of the Society of Neuro-Oncology (SNO).¹

The standard infusion rate of rituximab is 50 mg/hour for the first infusion and 100 mg/hour for subsequent infusions, with the rate increased by 50 mg/hour or 100 mg/hour every 30 minutes in the absence of infusion toxicity, respectively. Administering rituximab at a standard rate is meant to minimize the risk of infusion reactions, but long infusion times can be associated with increased health care costs and reduced patient satisfaction.

Rapid administration of rituximab during cycles 2 to 8 is approved by the U.S. Food and Drug Administration for some patients with previously untreated diffuse large B cell lymphoma and those with follicular lymphoma.

Researchers conducted a pilot study to determine if rapid infusion of rituximab is safe in patients with primary CNS lymphoma. For the study, researchers screened for patients with CNS lymphoma who had tolerated at least 1 previous rituximab infusion at the standard rate without experiencing a reaction and who did not receive concurrent chemotherapy on the day of rituximab infusion.

Of the 5 patients identified, 4 had received 1 standard infusion and 1 patient had received 3. All patients received premedication with acetaminophen and diphenhydramine prior to receiving rituximab at a dose of 500 mg/m² for diagnosis of primary CNS lymphoma. Two patients also received dexamethasone 2 mg daily during their first rapid infusion, but no other corticosteroids were administered during any other infusion.

None of the 5 patients had an infusion-related reaction during any rapid infusion of rituximab, suggesting that administration of rituximab over 90 minutes is safe and feasible in this population.

Reference

1. Modelevsky L, Tizon R, Garonce R, Reiss S, Kaley T. Safety and feasibility of rapid rituximab infusions in patients with primary CNS lymphoma. Neuro Oncol. 2016; 18(suppl 6):vi1.