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Prevention and management of obinutuzumab‐associated toxicities: Australian experience
Author(s) -
Snowden Alicia,
Hayden Ingrid,
Dixon Joanna,
Gregory Gareth
Publication year - 2015
Publication title -
international journal of nursing practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.62
H-Index - 55
eISSN - 1440-172X
pISSN - 1322-7114
DOI - 10.1111/ijn.12412
Subject(s) - obinutuzumab , chlorambucil , medicine , intensive care medicine , premedication , chronic lymphocytic leukemia , population , rituximab , dosing , adverse effect , oncology , chemotherapy , surgery , cyclophosphamide , leukemia , lymphoma , environmental health
Patients with chronic lymphocytic leukaemia (CLL) are typically diagnosed at an advanced age and may have multiple co‐existing conditions, augmenting the challenges of treating their CLL. Aggressive cytotoxic therapies are often poorly tolerated in this patient population. Obinutuzumab is a glycoengineered type II anti‐CD20 monoclonal antibody indicated in combination with chlorambucil for previously untreated CLL. The approval of this drug was based on the pivotal CLL11 trial, which demonstrated longer progression‐free survival vs. rituximab/chlorambucil and chlorambucil alone in patients with significant co‐existing medical conditions and/or poor renal function. However, a higher risk of infusion‐related reactions (IRRs) was demonstrated with obinutuzumab‐based therapy. We highlight important nursing care considerations to help prevent and successfully manage IRRs and other important adverse events, to improve the treatment experience of patients receiving obinutuzumab infusions and to enable them to complete their treatment and receive optimal benefit. Premedication, drug handling, dosing, administration, monitoring and documentation are discussed.