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Article

Impact of Split Dosing the First Rituximab Infusion in Patients with High Lymphocyte Count

1
Faculté de Pharmacie, Université Laval, Québec, QC G1V 0A6, Canada
2
Département de Pharmacie, Institut Universitaire en Santé Mentale de Québec, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Québec, QC G1J 2G3, Canada
3
Département de Pharmacie, Hôpital Sainte-Croix, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec, Drummondville, QC J2B 1C1, Canada
4
Département de Pharmacie, Hôtel-Dieu de Lévis, Centre Intégré de Santé et de Services Sociaux de Chaudière-Appalaches, Lévis, QC G6V 3Z1, Canada
5
Département de Pharmacie, Centre Hospitalier Affilié Universitaire Régional de Trois-Rivières, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec, Trois-Rivières, QC G8Z 3R9, Canada
6
Axe Oncologie, Centre de Recherche du CHU du Québec-Université Laval, Québec, QC G1S 4L8, Canada
7
Centre de Recherche du Centre Intégré de Santé et de Services Sociaux de Chaudière-Appalaches, Lévis, QC G6V 3Z1, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(5), 4118-4128; https://doi.org/10.3390/curroncol28050349
Received: 25 August 2021 / Revised: 6 October 2021 / Accepted: 9 October 2021 / Published: 13 October 2021
(This article belongs to the Section Hematology)
The most common adverse reactions to rituximab are infusion-related reactions (IRR). We evaluated the efficacy of split dosing the first rituximab infusion over two days to reduce IRR incidence in patients with hematological cancer and a high lymphocyte count. This is a retrospective observational study conducted in two healthcare centers in Quebec, Canada. The study enrolled patients with white blood cell counts ≥25.0 × 109/L who received their first rituximab dose for hematological cancer between December 2007 and May 2020. One healthcare center used asymmetrical split dosing, while the other used symmetrical split dosing. A total of 183 treatment episodes were collected from 143 patients. Among patients who received a fractionated dosing schedule, 42% developed an IRR from the first rituximab infusion compared with 50% for the standard protocol (adjusted relative risk, 0.89; p = 0.540). No significant difference was observed in IRR severity between either groups. However, 24% of patients who received the asymmetrical protocol developed an IRR compared to 68% for the symmetrical protocol (adjusted relative risk, 0.32; p = 0.003). These results suggest that an asymmetrical split dosing could be effective in reducing the incidence of IRR and is preferable to a symmetrical one. View Full-Text
Keywords: fractionated dosing schedule; high lymphocyte count; infusion-related reactions; rituximab; split dosing fractionated dosing schedule; high lymphocyte count; infusion-related reactions; rituximab; split dosing
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MDPI and ACS Style

Plante, M.; Garneau, L.; Laprise-Lachance, M.; Lemieux, P.; Dorval, M. Impact of Split Dosing the First Rituximab Infusion in Patients with High Lymphocyte Count. Curr. Oncol. 2021, 28, 4118-4128. https://doi.org/10.3390/curroncol28050349

AMA Style

Plante M, Garneau L, Laprise-Lachance M, Lemieux P, Dorval M. Impact of Split Dosing the First Rituximab Infusion in Patients with High Lymphocyte Count. Current Oncology. 2021; 28(5):4118-4128. https://doi.org/10.3390/curroncol28050349

Chicago/Turabian Style

Plante, Maude, Laurence Garneau, Magali Laprise-Lachance, Pierre Lemieux, and Michel Dorval. 2021. "Impact of Split Dosing the First Rituximab Infusion in Patients with High Lymphocyte Count" Current Oncology 28, no. 5: 4118-4128. https://doi.org/10.3390/curroncol28050349

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