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Plasmapheresis therapy for rare but potentially fatal reaction to rituximab
Author(s) -
Hastings Deborah,
Patel Bhavesh,
Torloni Antonio Sergio,
Mookadam Farouk,
Betcher Jeffrey,
Moss Adyr,
Heilman Raymond,
Mazur Marek,
Hamawi Khaled,
Mulligan David,
Reddy Kunam,
Mekeel Kristin,
Chakkera Harini
Publication year - 2009
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.20187
Subject(s) - plasmapheresis , medicine , rituximab , intensive care medicine , apheresis , surgery , immunology , antibody , platelet
Rituximab (Rituxan), a genetically engineered chimeric murine and human IgG1 monoclonal antibody directed against CD20 antigen, is an emerging drug used for a wide spectrum of disease processes and found to be relatively safe. We report a near‐fatal reaction to rituximab, which started 30 min after infusion and worsened over 24 to 48 h, resulting in hemodynamic and respiratory compromise that necessitated both intubation and high‐dose vasopressors. Subsequent treatment with plasmapheresis helped stabilize and improve the patient's clinical condition, and the patient was discharged home on hospital day 5. There is no specific treatment for these severe and sometimes fatal reactions except supportive care with plasmapheresis. With the increased use of rituximab therapy in the medical management of numerous diseases, those in the medical community need to be cognizant of the rare fatal or near‐fatal infusion reaction and the benefit that may accrue from plasmapheresis therapy. J. Clin. Apheresis, 2009. © 2009 Wiley‐Liss, Inc.