Maintenance Rituximab for me

I am glad to hear from you again Paella. And glad to hear that Mac's therapy is coming along.

While I never had SCT, I had 12 large-dose bage of rituxan during 12 R-ABVD infusions, but even with that, was never told I couldn't drive, so I would suspect driving is OK.  I never DID drive, and felt quite tired, but it was an 8 hour day receiving all of that stuff. My Benadryl was given before anything else, and usually wore off within the first hour or thereabout.

If anyone has been advised to not drive after just Rituxan, please submit the info.

max

Hi Sal,

The basic elements - as I understand them - that determine whether Rituximab is called for are the following:

Rituximab is a monoclonal antibody targeting CD20-positive B lymphocytes. It therefore helps eliminate the mutated - but also the normal - cells involved in B-cell lymphomas.

A maintenance course of Rituximab, inasmuch as it keeps the targeted lymphocytes at bay, aims to delay recurrence in those lymphomas deemed "incurable", i.e. essentially indolent (e.g. follicular) lymphomas.

There is, of course, some degree of controversy on the latter point among physicians, so your doctor's individual beliefs come into play in their decision regarding your treatment. Also, as treatment comes at a certain cost (financial and in terms of health risks), doctors reach a decision by balancing potential benefits and risks for each patient.

Assuming that you have B-type lymphoma, you may feel that Rituximab could have been part of your treatment. However, SCT being given with a curative intent, your doctors may feel confident (or have objective proof) that it is unnecessary, at this point in your treatment, to prescribe Rituximab to you.

As always, it cannot hurt to ask your hematologist the question regarding Rituximab maintenance in your case for a more precise, individually-tailored, answer.

Hope this helps.

PBL

lindary said:

My Rituxan maintenance

I recieve my treatment in the same infusion area as I did the R-Chop. It is about 5 - 5.5 hours now. The first 30 mins is the CBC, high dose of Benedryl (through the IV) and Tylenol. When doen it is about 15 mins to "unplug" and get my appt for the next one. 

Linda,

So to receive just Rituxan, along with the fluids and Benadryl, takes you about 5.5 hours ?

I ask because when I was getting R-ABVD my infusion day was ordinarily 8 hours, but the Rituxan was first, and did seem to take 4 hours or so. And after my first infusion day, my RN told my wife and I that I was getting everything "wide open," or the fastest drip rate possible, which would pretty much match the timetable you are now on.   That left four hours to do the other 4 bags, plus the necessary fluids.  Two of my remaining drugs were bags, but two were push-pull cylinders, which went very fast. 

By about the fourth hour each visit I was having to pull the IV tree to the restroom every 20 minutes or thereabout; almost continuously.    I felt like the Michelin Man floating above the Macy's Parade at the end, but was not drowsy, and believe I could have driven myself home if necessary.

I ask this partially because in the past I have read where people said they got their Rituxan infusion in an hour or two.  The only way I can explain that was that it was not the same dosage as I received, no way.

max

In response to the length of each of my Rituxin infusions, mine have always run pretty darn close to 7 hours.  That time is from stat to finish.  Registration, pre meds, only tylinal and benadrill, infurion and disconnect.  It can be given at a much faster rate, infusion 2/3 hours, if you are having a series of infusions.  Such as when you are receiving chem.  As I get 2 infusions every 6 months I don't qualify for the faaster infusions.  The practice of faster infusions started on the east coast several years ago and has moved west.  Most likely started so the centers could move patients in and out more quickly.  At least that's why Breast Cancer treatments changed from pills to infusions.  Where I go does not usually do the shorter infusions.  Hope this answers some questions.

PBL said:

Rituxan mode of administration

I have been wondering about all the comments I have read on this forum about the length of time involved in the administration of Rituxan.

Rituximab has been available as a subcutaneous injection in Europe and Australia for a couple of years now. It is administered as a five-minute shot in the patient's belly fat, followed by a 30-minute surveillance for possible reactions. Premedication (antihistamine, paracetamol and prednisone) can be taken orally an hour before the injection - for instance, before leaving home for the hospital. As this is more practical for patients as well as hospitals, it is now offered in the maintenance phase of treatment (initial injection must always be slow intravenous in case of a severe reaction requiring the injection to be stopped).

For some reason, it does not seem to have been made available in that form in the United States (for further reading: http://www.medscape.com/viewarticle/819736)...

Food for thought?

PBL,

Thanks for your interesting info.  I could not get your link to work, but found the following:

http://onlinelibrary.wiley.com/doi/10.1111/ijn.12413/full

I read the entire manufacturer's (Genetech) Dosing and Administration data sheet (see Section 2 ff).   This is interesting in that it fully delinneates IV FLOW RATES which US patients will find interesting in this discussion.  It never mentions Rituxan as an injection.   The article I linked states that many facets of Rituxan as injection are still under study and refinement.   No doubt, there is no telling when, or if, this form of delivery will come to the US.

Also for convenience:

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

http://www.rituxan.com/  (Click block at top of Homepage labeled "Perscribing Information and Medication Guide") This site is dated "2017"

max

Hi Paella,

I am so sorry, I don't know why I didn't see any of the posts since 2/2.  They show up as new, I just now saw it.  To answer your question, Bill did not have IVIG, just the rituxan.

Becky 

If this were to become avaiable in Hemo/Onc offices it has the potential to make it unavailable to people on Medicare.  As long as you go to the hospital it is covered however if given at your doctors office it may go into your prescription plan.  But the way things are going who knows if there will even be a Medicare for those elegable for it.

Not having to go to an infusion center and to receive it in a short appointment has alot of perks for many people.

Thank you PBL for the information.