Predictors of acute adverse events from rapid rituximab infusion

Purpose: This study aimed to identify the predictors of acute adverse events resulting from rapid rituximab infusion over 90 min. Method: It was a retrospective cohort study using medical record review based on a convenience sampling from 2007 till May 2011 in both in-patient and ambulatory setting in Royal Adelaide Hospital. Results: There were a total of 294 patients who received 376 courses and 1,571 cycles of rapid rituximab infusion. Forty-three (14.6 %) patients experienced acute adverse events of hypotension being the most commonly occurring events followed by patients feeling hot and face-flushed. There were 11 predictors analysed, namely age, gender, diagnosis, stage of disease, presence of cardiac or lung morbidities, type of treatment, number of course and cycles, total white blood cells count, lymphocyte counts and lactate dehydrogenase using log generalised estimating equation for univariate and multivariate analysis. The findings successfully demonstrated that high lymphocyte counts were the independent predictor of acute adverse event from rapid rituximab infusion (p = 0.0009). Patient with high lymphocyte counts were 6.9382 times the odd to experience an adverse event as compared to those with normal lymphocyte counts. Conclusion: There are no specific patient characteristics to preclude prescribing rapid rituximab infusion following a 90-min regimen for non-Hodgkin lymphoma except a potential for adverse events to occur when patients have abnormally high lymphocyte counts.