Survival Outcomes Associated With Infusion Reactions With Rituximab in Diffuse Large B-Cell Lymphoma

Experiencing an infusion reaction (IR) during treatment with rituximab was associated with higher overall survival (OS) for patients with diffuse large B-cell lymphoma (DLBCL), according to study results reported in Clinical Lymphoma, Myeloma & Leukemia.

The study was a retrospective, single-center cohort analysis of outcomes for adult patients with DLBCL (N=229) who either experienced an IR or did not during administration of an initial therapy containing rituximab.

The study authors reported that baseline characteristics were not significantly varied between the 2 cohorts in this study.

Presence or absence of a rituximab-related IR appeared significantly associated with OS in this study. At 5 years, there was a 74% lower risk of mortality associated with having an IR compared with not having one (hazard ratio [HR], 0.26; 95% CI, 0.07-0.95). Subgroup analyses suggested that improved OS with IRs may be particularly evident in patients with International Prognostic Index (IPI) scores of 0 to 3.

In an analysis that was adjusted for IPI score and c-Myc status, the presence of an IR also showed a significant, positive association with OS (HR, 0.002; 95% CI, 0.00-0.41; P =.02).

Subgroup analyses additionally suggested that IRs may be associated with increased progression-free survival (PFS) for patients having the germinal center subtype of DLBCL with c-Myc alterations (log-rank P <.0001). PFS was worst for patients with c-Myc alterations who did not have IRs.

“In summary, we observed that rituximab-related IRs are associated with significantly prolonged OS in patients with DLBCL,” stated the study authors in their report. The authors also indicated that this study’s results may suggest a role for complement-mediated cytotoxicity in rituximab’s efficacy.

Reference

Patel DA, Johanns TM, Trinkaus K, Bartlett NL, Wagner-Johnston N, Cashen AF. Implication of rituximab infusion reactions on clinical outcomes in patients with diffuse large B-cell lymphoma: A single institution experience [published online September 30, 2019]. Clin Lymphoma Myeloma Leuk. doi: 10.1016/j.clml.2019.09.604