ACTR-03. SAFETY AND FEASIBILITY OF RAPID RITUXIMAB INFUSIONS IN PATIENTS WITH PRIMARY CNS LYMPHOMA

Abstract

OBJECTIVES: To establish the safety and feasibility of rapidly infusing rituximab over 90 minutes in patients with primary CNS lymphoma. BACKGROUND: Administering rituximab at standard rate is meant to minimize infusion reactions though results in long infusion times with first doses averaging six hours and subsequent doses four hours. In a subset of patients with systemic B-cell mediated diseases, rapidly infusing subsequent rituximab doses over 90 minutes is safe, feasible, decreases healthcare costs, and improves patient satisfaction. We initiated a pilot study to determine if rapid infusion of rituximab is safe in patients with CNS lymphoma. METHODS: We reviewed all patients with CNS lymphoma who received rapid rituximab infusions from January 2016 to June 2016. Pilot inclusion criteria include age ≥18 years, tolerated ≥1 previous rituximab infusions at standard rate without reaction, and did not receive concurrent chemotherapy on day of infusion. Concomitant corticosteroids to control disease related neurologic symptoms were allowed. The primary endpoint was incidence of infusion reactions. RESULTS: Five out of nine patients screened for rapid rituximab infusion met criteria and a total of 21 infusions were administered. Patients had a median age of 61 years (range 45-63 years) and 4 were female. All patients received rituximab dosed at 500 mg/m2 for diagnosis of primary CNS lymphoma. Pre-medication consisted of acetaminophen and diphenhydramine. Prior to first rapid infusion, four patients received one standard infusion and one patient had received three. None of the five patients experienced a reaction during any rapid infusion. Two patients were on dexamethasone 2mg daily during their first rapid infusion. Steroids were not administered with any other infusion. CONCLUSION: Rapid administration of rituximab was safe and feasible for patients with primary CNS lymphoma.