Maintenance Rituximab for me

lindary

Treatment time

I had to go back and look at my previous appts. Looks like I am there for about 4.5 hours. I know they take vitals every 30 mins but I don't think I've counted how many times they take vitals. I would guess the Rituxan infusion itself is around 3 hrs. My next one is at the end of the month. I'll try ot pay more attention to when they start the infusion and when we are done. 

Max Former Hodgkins Stage 3

PBL said:

Sub Q

There shouldn't be any concern over Rituximab becoming available at a clinic - in fact, I have read numerous times that Rituximab - whatever the mode of administration - should "only be administered in an environment where full resuscitation facilities and close monitoring are immediately available", so I suspect that, while subcutaneous administration will save them time, it will never save patients a trip to the hospital.

Correct

PBL,

When I was looking for info regarding Rituxan injected via shot, I called the lead RN at my Survivorship Clinic, the place where I am followed for life, and where my annual labs are done and discussed.

She said she was an infusion nurse years before, and was the nurse who delivered the center's first-ever dose of Rituxan to a patient in the 90s.  The cancer center at that time was sort of subcontracted to the hospital, and even then had over 15 oncologists, and numerous branches across a lot of counties. It is now wholly-owned by the hospital system, has well over 20 oncologists, plus a dozen or so oncology surgeons.

She said that first patient went into some form of severe shock, and they had to bring her back...successfully, and the patient was even able to continue Rituxan therapy later.   But I do not envision Rituxan ever being given at a doctor's office during a walk-in.

Two of my drugs (Adriamycin and Vinblastine) were given as push-pull cylinders rather than as drip bags.  When I asked why that was, the nurse said because the drugs are vesicants, or blister agents, and cannot be allowed to spill. If they do spill, he said they have to call DHEC and set up an exclusion zone until it is cleaned up to DHEC standards.  Of course Rituxan in NOT a vesicant, but it is still serious stuff.

At my infusion center (around 40 infusion stations) I notices a device on wheels at the nurse's desk one day, and asked what it was; the answer was "the crash cart."  

What becomes routine and mundane for us over time really is not.  The first-ever chemo drug was developed in secret between government doctors and one of the world's premire cancer institutes toward the end of WW II.  And it was specifically used to treat leukemia and lymphoma.  Its name is Mustargen, derived from Mustard Gas, which is still tightly controlled by international Chemical Warfare protocols.  Mustargen is still a regular chemo drug today, in common use for a variety of cancers. It is a core drug in the HL combination MOPP.

https://en.wikipedia.org/wiki/Chlormethine

http://chemocare.com/chemotherapy/drug-info/Mustargen.aspx

max

PBL

Max Former Hodgkins Stage 3 said:

Correct

PBL,

When I was looking for info regarding Rituxan injected via shot, I called the lead RN at my Survivorship Clinic, the place where I am followed for life, and where my annual labs are done and discussed.

She said she was an infusion nurse years before, and was the nurse who delivered the center's first-ever dose of Rituxan to a patient in the 90s.  The cancer center at that time was sort of subcontracted to the hospital, and even then had over 15 oncologists, and numerous branches across a lot of counties. It is now wholly-owned by the hospital system, has well over 20 oncologists, plus a dozen or so oncology surgeons.

She said that first patient went into some form of severe shock, and they had to bring her back...successfully, and the patient was even able to continue Rituxan therapy later.   But I do not envision Rituxan ever being given at a doctor's office during a walk-in.

Two of my drugs (Adriamycin and Vinblastine) were given as push-pull cylinders rather than as drip bags.  When I asked why that was, the nurse said because the drugs are vesicants, or blister agents, and cannot be allowed to spill. If they do spill, he said they have to call DHEC and set up an exclusion zone until it is cleaned up to DHEC standards.  Of course Rituxan in NOT a vesicant, but it is still serious stuff.

At my infusion center (around 40 infusion stations) I notices a device on wheels at the nurse's desk one day, and asked what it was; the answer was "the crash cart."  

What becomes routine and mundane for us over time really is not.  The first-ever chemo drug was developed in secret between government doctors and one of the world's premire cancer institutes toward the end of WW II.  And it was specifically used to treat leukemia and lymphoma.  Its name is Mustargen, derived from Mustard Gas, which is still tightly controlled by international Chemical Warfare protocols.  Mustargen is still a regular chemo drug today, in common use for a variety of cancers. It is a core drug in the HL combination MOPP.

https://en.wikipedia.org/wiki/Chlormethine

http://chemocare.com/chemotherapy/drug-info/Mustargen.aspx

max

Poison Paradox...

Hello Max,

Indeed, all of those products routinely used to treat and control our diseases are anything but benign, as anyone who has experienced their side effects will testify.

Isn't it marvellous and ironic though, how we "lymphomaniacs" owe our survival to the wilful administration of such "life-saving poisons" as alcaloids from exotic periwinkle plants (Vincristine, Vinblastine), or the relatively novel (in the Western world) Bendamustine, one of those mustard-gas-derived chemo drugs developed in East Germany in the early 1960s...

Of course, unlike the chemo drugs per se, Rituxan is not a "poison". However, it occasionally can - and does - cause major allergic reactions in some patients, due to its chimeric (hamster/human) nature. Hence the antihistamine and prednisone premedication, slow infusion, close surveillance - and also, of course, the crash cart near at hand. The reassuring bit is that the first Rituxan infusion is often the one that causes the strongest reaction - and then we somehow get used to it...

PBL

lindary

more on time

This is just an FYI.

I kept track of my time during my Rituxan treatment yesterday. First part was about an hour with the blood test, tylenol/benedryl. The Rituxan was about 3 hours. This includes vitals being taken 4 times plus the final flush. Then 15 mins to unplug and cleanup.  

tryshz

and more on treatment time...

I had my second Rituxan maintenance treatment on February 22 - and I timed - was very similar to lindary's. The pre-meds took about an hour to go thru, then the Rituxan took just over two hours for me. After that, unhooked and out the door.  

richlam

Maintenance Rituximab

My maintenance Rituxan was every two months for two years. This was after 6 months of B+R.  I had not had any major reactions to the Rituxan so the infusions had gone to the fastest rate.  After the pre-meds the R infusion was only about an hour.  I would only be there a total of a couple hours including bloodwork beforehand.  I did not get the IVIG. I always drove myself to and from the infusion center and generally finished the day off at my normal job. Remember everybody is differeent and you will figure out what works for you, afterall you have three years to see what works best.