Evaluation of the safety and feasibility of rapid rituximab infusion.

AIM: To assess safety of rapid infusion by measuring infusion-related side effects and toxicities. METHODS: Participants received the first rituximab infusion according to the manufacturers' recommendations. If well-tolerated, they then received the second and subsequent infusions at a rate of 20% of the dose over the first 30 min and the remaining 80% over the next hour. Premedication was administered for all the infusions. RESULTS: A total of 243 infusions in 65 consecutive participants were evaluated. Six experienced a grade 1 reaction and one a grade 3 transfusion-related adverse event. Three of these participants were withdrawn from the rapid infusion study. The other four participants (grade 1 only participants) were re-challenged. The same premedication was used as in the first rapid infusion. On experiencing a grade 1 reaction, promethazine 12.5 mg i.v. was administered and infusion recommenced at 50% of the previous rate upon the resolution of symptoms. Three patients developed a grade 1 adverse event and one patient experienced no adverse reaction. The three patients who did not tolerate the second rapid infusion were withdrawn from this study. CONCLUSION: A rituximab infusion over 90-min was safe and feasible for participants who seek treatment at ambulatory cancer centre. The new regimen has been adopted as a standard practice with better resource utilization.

The impact of methods of information on chemotherapy-related side effects.

A systematic review of the literature regarding the effectiveness of various methods of information given to patients with cancer receiving chemotherapy education revealed that psycho-educational interventions minimized the intensity and impact of treatment-related fatigue on daily life in the short term for patients undergoing chemotherapy. Studies that investigated efficacy of interactive multimedia devices revealed no statistical improvement in information recall, quantity of self-care activities, and fatigue levels between groups. Three of the multimedia studies focused on anxiety and depression trends before and during treatment, with mixed results. Several studies revealed no significant difference in either anxiety or depression. Others concluded that patients who viewed video information in conjunction with standard care were less anxious and depressed. Combined, these studies revealed that multimedia devices did not improve recall of information and that psycho-educational interventions were able to improve the impact of treatment-related side effects, namely fatigue, in the short term. This suggests that the educational needs of patients with cancer require a complex series of factors that impact the individual's ability to understand how and when to initiate recommended self-care strategies.