Table 1. Outcomes of patients treated... | American Society of Hematology

Table 1.

Outcomes of patients treated with obinutuzumab after rituximab intolerance

Patient number	Age (y)	Hematologic disorder	Grade of rituximab reaction leading to discontinuation	Description of rituximab reaction	Doses of rituximab before DHR leading to discontinuation (excluding desensitizations)	Serum sickness	Rituximab desensitization protocol used	Regimen with obinutuzumab	Line of therapy obinutuzumab was added to	DHR to obinutuzumab of any grade	Decription of obinutuzumab reaction	Grade 3+ DHR to obinutuzumab	Obinutuzumab discontinuation due to DHR	Total doses of obinutuzumab given	Best response
1	38	TTP	Grade 3	Severe arthralgia, rash, malaise, and fever	6	Yes	No	Monotherapy	3	Yes	Nausea, light-headedness, and rigors with recurrence of symptoms	Yes	No	3	CR
2	64	MZL	Grade 3	Uticarial rash	6	No	No	Obinutuzumab + bendamustine	2	No	N/A	No	No	4	CR
3	62	MZL	Grade 4	Anaphylaxis	1	No	No	Obinutuzumab + bendamustine	1	Yes	Mild rigors that resolved without stopping infusion	No	No	2	No response documented
4	73	Transformed DLBCL from LPL	Grade 3	Itching, chest pressure radiating to left arm, numbness, chills, and neurotoxicity	2	No	Yes	Obinutuzumab + CHOP	6	No	N/A	No	No	6	CR
5	81	DLBCL	Grade 4	Hemodynamic instability, unresponsive, subsequent code blue with epinephrine use	1	No	No	Obinutuzumab + mini-CHOP	1	Yes	Flushing, shortness of breath, hypertension, and rigors	Yes	Yes	1	No response documented
6	75	LPL	Grade 3	Flushing, neck rash, shortness of breath, hypotension with syncope, and rigors	7	No	No	Obinutuzumab + bendamustine	2	No	N/A	No	No	4	CR
7	65	Nodal MZL	Grade 3	Fever, rash, itching, and myalgia	11	Yes	No	Obinutuzumab + bendamustine	3	No	N/A	No	No	2	CR
8	41	FL	Grade 4	Hives, throat closing, and shortness of breath	1	No	Yes	Obinutuzumab + lenalidomide	5 and 7	No	N/A	No	No	12	PR
9	64	MCL	Grade 3	Fever, rash, and myalgia	1	Yes	No	Obinutuzumab + lenalidomide	4	Yes	Rigors and nausea	No	No	2	No response documented
10	72	Transformed CNS DLBCL from FL	Grade 4	Anaphylaxis	6	No	Yes	Obinutuzumab + high dose methotrexate	3	No	N/A	No	No	6	PR
11	54	Cold agglutinin–induced hemolytic anemia and thrombocytopenia with MAP2K1- mutated HCL	Grade 4	Hypoxemia, hives, and bradycardia	1	No	No	Trametinib + obinutuzumab	8	Yes	Chills, rigors, nausea	No	No	9	Baseline transfusion dependent to Hg >10 and plt >100 000 for 6 months
12	66	LPL	Grade 3	Diffuse myalgia and limb swelling	2	No	No	Obinutuzumab + bendamustine	1	No	N/A	No	No	3	CR
13	61	FL	Grade 3	Fever, rash, and myalgia	1	Yes	No	Obinutuzumab + bendamustine	1	No	N/A	No	No	5	CR
14	59	LPL	Grade 3	Fever, rash, and myalgia	4	Yes	No	Obinutuzumab + bendamustine	1	No	N/A	No	No	2	PR
15	70	MZL	Grade 3	Myalgia leading to gross motor dysfunction	2	Yes	No	Obinutuzumab + bendamustine	1	No	N/A	No	No	2	Has not completed therapy to date
16	78	MZL	Grade 3	Unspecified infusion-related reaction	1	No	No	Obinutuzumab + bendamustine	4	Yes	Chest tightness, nausea, shortness of breath	No	No	3	Has not completed therapy to date
17	69	Multiple episodes of EBV reactivation	Grade 3	Rash	6	No	No	Obinutuzumab	2	No	N/A	No	No	14	Undetectable EBV by PCR

Patient number	Age (y)	Hematologic disorder	Grade of rituximab reaction leading to discontinuation	Description of rituximab reaction	Doses of rituximab before DHR leading to discontinuation (excluding desensitizations)	Serum sickness	Rituximab desensitization protocol used	Regimen with obinutuzumab	Line of therapy obinutuzumab was added to	DHR to obinutuzumab of any grade	Decription of obinutuzumab reaction	Grade 3+ DHR to obinutuzumab	Obinutuzumab discontinuation due to DHR	Total doses of obinutuzumab given	Best response
1	38	TTP	Grade 3	Severe arthralgia, rash, malaise, and fever	6	Yes	No	Monotherapy	3	Yes	Nausea, light-headedness, and rigors with recurrence of symptoms	Yes	No	3	CR
2	64	MZL	Grade 3	Uticarial rash	6	No	No	Obinutuzumab + bendamustine	2	No	N/A	No	No	4	CR
3	62	MZL	Grade 4	Anaphylaxis	1	No	No	Obinutuzumab + bendamustine	1	Yes	Mild rigors that resolved without stopping infusion	No	No	2	No response documented
4	73	Transformed DLBCL from LPL	Grade 3	Itching, chest pressure radiating to left arm, numbness, chills, and neurotoxicity	2	No	Yes	Obinutuzumab + CHOP	6	No	N/A	No	No	6	CR
5	81	DLBCL	Grade 4	Hemodynamic instability, unresponsive, subsequent code blue with epinephrine use	1	No	No	Obinutuzumab + mini-CHOP	1	Yes	Flushing, shortness of breath, hypertension, and rigors	Yes	Yes	1	No response documented
6	75	LPL	Grade 3	Flushing, neck rash, shortness of breath, hypotension with syncope, and rigors	7	No	No	Obinutuzumab + bendamustine	2	No	N/A	No	No	4	CR
7	65	Nodal MZL	Grade 3	Fever, rash, itching, and myalgia	11	Yes	No	Obinutuzumab + bendamustine	3	No	N/A	No	No	2	CR
8	41	FL	Grade 4	Hives, throat closing, and shortness of breath	1	No	Yes	Obinutuzumab + lenalidomide	5 and 7	No	N/A	No	No	12	PR
9	64	MCL	Grade 3	Fever, rash, and myalgia	1	Yes	No	Obinutuzumab + lenalidomide	4	Yes	Rigors and nausea	No	No	2	No response documented
10	72	Transformed CNS DLBCL from FL	Grade 4	Anaphylaxis	6	No	Yes	Obinutuzumab + high dose methotrexate	3	No	N/A	No	No	6	PR
11	54	Cold agglutinin–induced hemolytic anemia and thrombocytopenia with MAP2K1- mutated HCL	Grade 4	Hypoxemia, hives, and bradycardia	1	No	No	Trametinib + obinutuzumab	8	Yes	Chills, rigors, nausea	No	No	9	Baseline transfusion dependent to Hg >10 and plt >100 000 for 6 months
12	66	LPL	Grade 3	Diffuse myalgia and limb swelling	2	No	No	Obinutuzumab + bendamustine	1	No	N/A	No	No	3	CR
13	61	FL	Grade 3	Fever, rash, and myalgia	1	Yes	No	Obinutuzumab + bendamustine	1	No	N/A	No	No	5	CR
14	59	LPL	Grade 3	Fever, rash, and myalgia	4	Yes	No	Obinutuzumab + bendamustine	1	No	N/A	No	No	2	PR
15	70	MZL	Grade 3	Myalgia leading to gross motor dysfunction	2	Yes	No	Obinutuzumab + bendamustine	1	No	N/A	No	No	2	Has not completed therapy to date
16	78	MZL	Grade 3	Unspecified infusion-related reaction	1	No	No	Obinutuzumab + bendamustine	4	Yes	Chest tightness, nausea, shortness of breath	No	No	3	Has not completed therapy to date
17	69	Multiple episodes of EBV reactivation	Grade 3	Rash	6	No	No	Obinutuzumab	2	No	N/A	No	No	14	Undetectable EBV by PCR

CHOP, cyclophosphamide, doxorubicin, vincristine, and prednisone; CNS, central nervous system; DLBCL, diffuse large B-cell lymphoma; FL, folicular lymphoma; HCL, hairy cell leukemia; Hg, hemoglobin; LPL, lymphoplasmacytic lymphoma; MCL, mantle cell lymphoma; MZL, marginal zone lymphoma; N/A, not applicable; PCR, polymerase chain reaction; plt, platelet; TTP, thrombotic thrombocytopenia purpura.

View Large

This Feature Is Available To Subscribers Only