Rapid infusion of rituximab is well tolerated in children with hematologic, oncologic, and rheumatologic disorders

Bernhardt, M. Brooke; Guzman, Marietta M. de; Grimes, Amanda; Kirk, Susan E.; Nelson, Sheryl; Bergsbaken, Jessica; Minard, Charles G.; Despotovic, Jenny M.

doi:10.1002/pbc.26759

Cited by 5 publications

(9 citation statements)

References 19 publications

(34 reference statements)

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“…Most recently, the first prospective study of rapid rituximab infusion in pediatric patients with hematologic, oncologic, and rheumatologic disorders was published. 7 Rapid infusion of rituximab in the pediatric patients in these studies was well tolerated in 90% to 97% of patients.…”

Section: Introductionmentioning

confidence: 79%

“…The median number of doses of rapid rituximab infusion received per patient was 4 (range. [1][2][3][4][5][6][7][8][9][10][11][12]. All patients received a rituximab dose of 375 mg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Legeay et al 21 reported a 2.7% incidence in 17 patients who received a total of 37 infusions. Bernhardt et al 7 noted a higher incidence of adverse events (10%); however, these events were categorized as low grade, and there were no dose-limiting, infusion-related adverse events. Our patient cohort included both malignant and nonmalignant indications.…”

Section: Discussionmentioning

confidence: 98%

“…The safety profile of rapid rituximab found within our institution is similar to that of other reports. Our institution's protocol calls for the administration of rituximab during the course of 90 minutes in a titrated manner similar to that described by Legeay et al 21 and Bernhardt et al 7 Bernhardt et al 7 were also the first to report the use of rapid-infusion rituximab in pediatric rheumatologic patients, which was given as a 120-minute infusion as opposed to 90 minutes. In the report by Wallace et al, 20 rituximab was administered during the course of 60 minutes in patients with non-malignant conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequent doses may be infused at an initial rate of 1 mg/kg/hr. 7 This titration method results in rituximab administration during the course of 4 to 6 hours for the first dose and 2 to 4 hours for subsequent infusions. Long infusion times result in a significant burden on both the patient and the health care institution, requiring increased nursing resources and extended chair time.…”

Section: Introductionmentioning

confidence: 99%

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Rapid-Infusion Rituximab in a Pediatric Population

Gaffney¹,

Dahl²,

Stanton³

et al. 2020

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVES The use of rapid rituximab infusion in certain pediatric populations has generally been regarded as safe. The safety of our institution's rapid rituximab protocol was evaluated. METHODS The primary end point was the number of and severity of adverse drug reactions. Secondary end points included a description of the patient population defined by the indication, dose, and number of rituximab infusions administered. Additionally, the difference in infusion times in hours of those receiving rapid rituximab infusions versus the theoretical infusion time of subsequent administration rate schedules was defined. RESULTS A total of 88 infusions for 22 patients were reviewed. No dose-limiting adverse reactions were observed. Three patients experienced grade 1 isolated infusion-related adverse events during a single infusion encounter. Two of the three patients received additional doses of rapid rituximab infusions without incident, whereas the other patient no longer required rituximab therapy. CONCLUSIONS The use of a 90-minute rituximab infusion protocol in pediatric patients with non-rheumatic diseases was well tolerated.

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Section: Introductionmentioning

confidence: 79%

“…The median number of doses of rapid rituximab infusion received per patient was 4 (range. [1][2][3][4][5][6][7][8][9][10][11][12]. All patients received a rituximab dose of 375 mg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Rapid-Infusion Rituximab in a Pediatric Population

Gaffney¹,

Dahl²,

Stanton³

et al. 2020

The Journal of Pediatric Pharmacology and Therapeutics

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Patterns of B Cell Repletion Following Rituximab Therapy in a Pediatric Rheumatology Cohort

Mitchell

Crayne

Cron

2019

ACR Open Rheumatology

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ObjectiveTo investigate the association between demographic characteristics, disease characteristics, the number of rituximab (RTX) rounds, and concurrent immunosuppression on B cell level repletion following RTX therapy.MethodsA retrospective chart review of 112 children who met inclusion criteria and were treated with RTX at a single institution was performed. Demographic, clinical, and laboratory data were extracted and compared. CD19 levels were reviewed at 6 and 12 months post‐RTX with depletion defined as fewer than 10 cells/μL and complete repopulation to normal levels defined as 170 cells/μL or more.ResultsAmong patients with CD19 levels, 48% of patients remained depleted at 6 months, 89% were repleted with 10 cells/μL or more by 12 months, and 46% remained below normal levels at 12 months following infusion. There was no significant association between the number of RTX rounds or underlying disease and persistent depletion below normal levels at 12 months following RTX infusion. Depletion at 6 months was associated with a 79% chance of persistent depletion below normal levels at 12 months. The association between concurrent cyclophosphamide (CYC) and repletion of 10 cells/μL or more at 6 (P = 0.091) and 12 months (P = 0.087) trended toward significance with no significant association between CYC and persistent depletion below normal levels.ConclusionRTX therapy for pediatric rheumatic diseases is well‐tolerated and results in variable repletion and normalization of B cell numbers at 6 and 12 months. B cell repletion in children is variable and independent of underlying disease and of the number of RTX infusions.

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New approaches to therapeutic drug development for childhood cancers

Campbell

DuBois

2020

Current Opinion in Pediatrics

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Purpose of review We provide an overview of the current landscape of drug development relevant to childhood cancers. We present recent and ongoing efforts to identify therapeutic targets in pediatric cancers. We describe efforts to improve the approach to clinical trials and highlight the role regulatory changes and multistakeholder platforms play in advancing pediatric cancer drug development. Recent findings Expanding knowledge of the genetic landscape of pediatric malignancies through clinical genomics studies has yielded an increasing number of potential targets for intervention. In parallel, new therapies for children with cancer have shifted from cytotoxic agents to targeted therapy, with examples of striking activity in patients with tumors driven by oncogenic kinase fusions. Innovative trial designs and recent governmental policies provide opportunities for accelerating development of targeted therapies in pediatric oncology. Summary Novel treatment strategies in pediatric oncology increasingly utilize molecularly targeted agents either as monotherapy or in combination with conventional cytotoxic agents. The interplay between new target identification, efforts to improve clinical trial design and new government regulations relevant to pediatric cancer drug development has the potential to advance novel agents into frontline care of children with cancer.

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Rapid infusion of rituximab is well tolerated in children with hematologic, oncologic, and rheumatologic disorders

Cited by 5 publications

References 19 publications

Rapid-Infusion Rituximab in a Pediatric Population

Rapid-Infusion Rituximab in a Pediatric Population

Patterns of B Cell Repletion Following Rituximab Therapy in a Pediatric Rheumatology Cohort

New approaches to therapeutic drug development for childhood cancers

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