Site Editor
Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Tuesday, January 21, 2025
In patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) taking the monoclonal antibody obinutuzumab in the first or subsequent line of treatment, researchers have found that only pretreatment absolute lymphocyte count—of all variables evaluated—is a statistically significant predictor (P = .027) for increased odds of experiencing an infusion-related reaction. Writing in the journal JADPRO, Donald C. Moore, PharmD, BCPS, BCOP, DPLA, FCCP, of Atrium Health Levine Cancer Institute, Charlotte, North Carolina, and colleagues also noted the rate of these reactions in a real-world population of patients with CLL or SLL was comparable to those reported in most phase III clinical trial results, given split dosing and standard premedication.
No clinical risk factors had previously been identified that predicted infusion-related reactions, explained the team, although it was known that obinutuzumab was linked to higher rates of severe (≥ grade 3) infusion-related reactions than rituximab. They performed their multicenter, retrospective analysis of 68 patients with untreated or previously treated CLL or SLL in the hopes of discovering factors to help clinicians in practice determine patient-specific risks. The patients all had Rai stage III and IV CLL or SLL (median age, 70 years; 61.8% male).
Other factors they included that were ultimately not statistically significantly related to the incidence of infusion-related reactions were stage, patient age, performance status, and pretreatment level of lactate dehydrogenase. All-grade and severe infusion-related reactions were reported in 25% and 1.5% of patients, respectively.
Although the current standard strategies to prevent infusion-related reactions in patients using obinutuzumab remain important, better approaches should be researched and implemented, declared Dr. Moore and co-investigators. Pending future studies, “such strategies could include the omission of split dosing or shortened infusions for low-risk patients and provision of heightened monitoring and stringent adherence to premedication and split-dose strategies for high-risk patients, similar to those implemented for rituximab.”
Disclosure: For full disclosures of the study authors, visit jadpro.com.
