- Non-Hodgkin's lymphoma (CD-20 positive, B-cell)
- Transplant-related lymphoma
- Available as a 10 mg/mL solution. Refrigerate.
- Dilute dose in NS or D5W to a concentration of 1-4 mg/mL. DO NOT SHAKE BAG. Invert gently to mix.
- Diluted solutions stable 24 hours refrigerated and at room temperature for additional 12 hours; if not refrigerated -stable 12 hours at room temperature
- Solutions Compatible: D5W, NS
NO COMPATIBILITY information with other drugs. Run in dedicated line; do not mix with any other drug
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
|IV Intermittent Infusion||
|IV Continuous Infusion||NO|
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
- 375 mg/m2 every 1-3 weeks for 4-8 doses total
** Dosage may differ according to protocol
- Premedication with diphenhydramine (Benadryl®) and acetaminophen is mandatory. Reactions generally occur 30 minutes to 2 hours after the start of the first infusion. If reaction occurs, stop infusion temporarily and notify physician.
- Infusion-related Syndrome: consists of allergic reactions (eg. rash, urticaria, fever, chills, bronchospasm, angioedema) and other symptoms (eg. flushing, hypotension, rhinitis, nausea, asthenia, headache)
- Tumor Lysis Syndrome: consists of hyperuricemia, hyperkalemia, hypocalcemia, acute renal failure, elevated LDH and high fever. Risk factors include: high numbers of circulating blasts or large tumor burden. Tumor Lysis Syndrome usually will occur within 1-2 hours of first infusion, but can be delayed until 12-24 hours after.
- Cytokine Release Syndrome (rare 4-7 patients/10,000) may occur within 24 hours of first infusion and can be fatal. Large tumor burden is risk factor.
- Severe pulmonary events (rare) such as bronchospasm, dyspnea, hypoxia, pulmonary infiltrates and acute respiratory failure may occur within 1-2 hours after starting the first infusion. Patients with pre-existing pulmonary insufficiency or tumor infiltration of the lungs are at higher risk.
- Treatment for unusual side effects are available through the study chair identified on the front page of the protocol and/or pharmacy
- See pre-printed orders for premedication doses and mandatory monitoring protocol (pulse, respiratory rate, blood pressure every 15 minutes while increasing rate)
- Anaphylaxis precautions are necessary; have available at bedside: diphenhydramine, hydrocortisone, and epinephrine. Ventolin nebules may be indicated for respiratory difficulty.