title: A clinical prediction model for infusion-related reactions to rituximab in patients with B cell lymphomas.
abstract: Background Infusion-related reactions (IRRs) are a major adverse event of rituximab. Objective To develop a prediction model for IRRs to rituximab among patients with B cell non- Hodgkin's lymphomas (B-NHL). Setting A 1000-bed university hospital in Tokyo. Methods Patients with B-NHL treated with rituximab at our institution from 2004 to 2014 were retrospectively analysed. Chills, fever, rash, nausea, asthenia, headache, cardiovascular symptoms, and respiratory symptoms of any grade, in association with rituximab infusion, were identified as IRRs. Risk factors for IRRs to rituximab found in the intergroup analysis were subsequently evaluated by using multivariate analysis. Main outcome measure Occurrence of IRRs to rituximab. Results A total of 140 patients with various types of B-NHL, including 74% with diffuse large Bcell lymphoma, were analysed. Among them, 55 and 85 patients were assigned to the IRR group and the non-IRR group, respectively. Indolent histological subtypes, bulky disease (>10 cm), B symptoms, higher serum soluble interleukin-2 receptor concentration, and bone marrow involvement were more common in the IRR group. The multivariate logistic regression analysis identified low-grade lymphomas [odds ratio (OR) 2.81, p = 0.017] and bulky disease (OR 2.52, p = 0.037) as independent risk factors for IRRs to rituximab. The incidence rates of IRRs to rituximab among patients with neither, one, or both of these risk factors were 26, 54, and 78%, respectively (χ2= 16.4, p < 0.001). Conclusions A simple combination of histopathological subtype and bulkiness of disease could predict the risk of IRRs to rituximab among patients with B-NHL.
authors.affiliation: Department of Pharmacy, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.|Tumor Center, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hayama
authors.affiliation: Tumor Center, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan. miura.katsuhiro@nihon-u.ac.jp.|Department of Hematology and Rheumatology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan. miura.katsuhiro@nihon-u.ac.jp.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Pharmacy, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.|Tumor Center, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Uchiike
authors.affiliation: Department of Hematology and Rheumatology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: Department of Pharmacy, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tsutsumi
authors.affiliation: Department of Hematology and Rheumatology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakagami
authors.affiliation: Department of Pharmacy, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yoshida
authors.affiliation: Department of Hematology and Rheumatology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi Ward, Tokyo, 173-8610, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Takei
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous / Q000009:adverse effects*; D016393:Lymphoma, B-Cell / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab / Q000008:administration & dosage*
chemical_list: D000069283:Rituximab
keywords: B-cell non-Hodgkin’s lymphoma; CD20; Infusion-related reactions; Rapid infusion; Rituximab