Tumor lysis syndrome rituximab

Rituximab -monoclonal antibody to CD20 (B-cell surface antigen) -fever, chills, malaise -nausea, vomiting -flushing -bronchospasm, angioedema, urticaria -rhinitis -pain at disease sites -tumor lysis syndrome may occur in patients with high peripheral lymphocyte count... 

Severe reactions to rituximab are rare, but are seen in patients with bulky tumors or with leukemic involvement with high numbers of CD20 positive cells (6,7) and were ascribed to a rapid tumor lysis syndrome (6,8,9). In 11 patients with mahgnant B cell leukemia, first-dose reactions were significantly more severe in patients whose basehne lymphocyte count was higher than 50 X 10 /1 and were also associated with raised peak serum concentrations of tumor necrosis factor aha and interleukin-6 (10). 

In general, the MoAbs used in treating cancer are relatively well tolerated compared with conventional cytotoxic chemotherapy. The main adverse effect associated with rituximab use is infusion-related or hypersensitivity reactions. Patients may experience fever, rigors, dyspnea, hypotension, and rarely anaphylactoid reactions. Premedication with acetaminophen, diphenhydramine, and corticosteroids can reduce these reactions. Patients with significant tumor burden at the time of first treatment with rituximab may experience tumor lysis syndrome, and appropriate measures should be implemented to prevent this complication in these patients. 

Rituximab CD20 Non-Hodgkins lymphoma Fever, infusion reactions, tumor lysis syndrome, infections, progressive multifocal leukoencephalopathy (PML)... 

Rituximab An++, C+, D++, M+, P+, R++ Severe, fatal hypersensitivity reaction possible. Tumor lysis syndrome has caused acute renal failure. Potentially fatal mucocutaneous reactions reported,... 

Reactions following initial infusions of antibody are common, but these can usually be handled by a cautious rate of infusion, appropriate hydration and diuresis, and, if necessary, praned-ication. Twenty six percent of initial reactions are reported to be mild, 48 % moderate, and 26 % severe. The initial infusion reaction to some mAbs, for example, rituximab (see below), may provoke tumor lysis syndrome, cytokine release syndrome, and systemic inflammatory response syndrome. Tumor lysis syndrome, noted particularly with rituximab, can occur following cancer treatment and sometimes without treatment. It is believed to be the result of breakdown products of cancer cells leading to increased levels of some metabolites and reflected in conditions such as hypercalcemia, hyperkalemia, hyperphosphatemia, acute uric acid nephropathy, and acute renal failure. The syndrome can occur in the early stages of mAb therapy and is potentially life-threatening. Cytokine release syndrome, also called cytokine storm, is commonly seen after... 

Initial infusion reaction to some mAbs, for example, rituximab, may provoke tumor lysis syndrome, cytokine release syndrome, and systemic inflammatory response syndrome. 

Rituximab (Rituxan/ MabThera) CD20 1997 Not conducted No information 2-month monkey B-cell depletion Tumor lysis syndrome (TLS), progressive multifocal leukoencephalopathy (PML), hepatitis B, infections, cardiac arrhythmias and angina, bowel obstruction and perforation, cytopenias... 

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