Rituxan, the registered name for rituximab, is considered a frontline treatment for certain leukemias and B-cell lymphomas. Rituxan is also prescribed for patients with rheumatoid arthritis who do not respond to other therapies. Rituxan is given either in combination with other chemotherapy drugs; alone as a single-agent treatment; or as a maintenance dose over several years. Rituxan works by binding to the CD20 protein on the surface of malignant B cells, causing them to die.
Heart Problems
Rituxan may cause a short-term drop in blood pressure. Tell your doctor if you have chest pain, irregular heartbeat or high blood pressure, or if you are taking any medication for heart problems. Your doctor may order tests before Rituxan treatment to see if your heart is healthy.
Infusion Reactions
Rituxan is generally given by infusion, and common reactions occur during the first infusion, including fever, chills, skin rash, swollen lips or tongue, shortness of breath, sore throat, chest pain and abdominal pain. During the entire course of Rituxan treatment, other reactions may appear, including headache, nausea, vomiting, fatigue, dizziness and itchiness. Tell your doctor if you experience any of these symptoms.
Tumor Lysis Syndrome
Tumor Lysis Syndrome can occur after Rituxan treatment (and sometimes before) in patients with a heavy tumor burden. The decomposing cancerous B cells release toxins, such as uric acid, which may lead to acute renal failure. Your doctor may want to prescribe additional treatment during chemotherapy to inhibit uric acid build-up and to keep you hydrated.
Progressive Multifocal Leukoencephalopathy
Progressive Multifocal Leukoencephalopathy is a rare but usually fatal brain disease. It can occur after Rituxan treatment and is caused when the JC virus attacks the brain in patients with an immune system compromised by chemotherapy. Symptoms are similar to those of a stroke and include blurred vision, loss of coordination, speech impairment, memory loss, and weakness in arms and legs. Call your doctor immediately if you experience any of these symptoms.
Hepatitis B Reactivation
Patients with chronic Hepatitis B infection may experience a reactivation of the disease after Rituxan treatment because the chemotherapy weakens the immune system. Reactivation of Hepatitis B may lead to liver failure. Tell your doctor before treatment with Rituxan if you have ever had Hepatitis B or if you currently have chronic Hepatitis B.
Blood Counts
Rituxan can affect your blood count and can lead to anemia (low red blood cell count) or neutropenia (low white blood cell count). Your doctor may want to monitor your blood count each week while you are under treatment.
References
- "Hematology/Oncology Clinics of North America"; Monoclonal antibody therapy with rituximab for acute lymphoblastic leukemia; Thomas DA, O'Brien S, Kantarjian HM; October 2009.
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