Safety of a rapid, 90-minute rituximab infusion protocol.

e18551 Background: Trials have reported safety with rapid, 90-minute rituximab infusions (RRI). After conducting a pilot study in 2010, our institution adopted a policy to screen patients for RRI eligibility. The objectives of this study were to review data for policy implementation and assess RRI safety and infusion time reduction. Methods: A retrospective review was conducted for patients who received rituximab from 08/2010 to 12/2010. RRI inclusion criteria were age ≥ 18 years, ≥ 1 rituximab infusion in prior 90 days, dose ≤ 1000mg, and dose ≤ 375mg/sqm. Exclusion criteria were a history of ≥ grade 3 reaction to rituximab infusion, physician exclusion, and indication for arthritis, lupus, or transplant. Patients were screened prospectively and medical records were reviewed to identify infusions which qualified for RRI. The incidence of infusion reaction and length of infusion was compared for rapid vs. non-rapid infusions. Statistical tests used were Chi Squared, Fischer’s exact test, and Mann Whitney U. Results: One-hundred and twenty-seven infusions (54 patients) qualified for RRI. Eighty-seven (69%) were successfully converted to RRI. Patient demographics and outcomes are listed in the table. There was no difference in the incidence or severity of infusion reaction for rapid vs. non-rapid (1% vs. 3%, P = 0.532). Only two grade 2 infusion reactions were observed during this study. Rapid infusions were shorter than non-rapid infusions (median minutes; 90 vs. 180, P < 0.0001). The outpatient infusion clinic realized a 93-hour reduction in infusion time over 4 months by utilizing RRI. Conclusions: This RRI protocol reduced infusion times and did not appear to increase the incidence of infusion reactions. Rapid Non-rapid Patients – No. 43 29 Age – Median (IQR) 63 (53-75) 67 (54-80) Male – No. (%) 21 (49%) 18 (62%) White – No. (%) 31 (72%) 22 (76%) Histology NHL – No. (%) 29 (67%) 23 (79%) ITP/TTP – No. (%) 6 (14%) 4 (14%) Leukemia – No. (%) 4 (9%) 2 (7%) Other – No. (%) 4 (9%) 0 (0%) Infusions – No. 87 40 Infusion reaction – No. (%) 1 (1%) 1 (3%) Infusion length – Min. (IQR) 90 (90-100) 180 (150-225) Outpatient – No. (%) 62 (71%) 21 (53%) Acute care – No. (%) 25 (29%) 18 (45%) ICU – No. (%) 0 (0%) 1 (3%) APAP – No (%) 81 (93%) 29 (73%) Diphenhydramine – No (%) 83 (95%) 37 (93%)