Avoid live vaccines

Renal toxicity with cisplatin

Other monoclonal antibodies

DMARDs

Cardiotoxics

Antihypertensives

Relapsed or chemoresistent stage III- IV folicullar lymphoma

Fever, chills Rigors, nausea Rash, urticaria

Pruritus Angioedema Asthenia Headache,throat irritation

Rhinitis, bronchospam Vomiting,

Myalgia, dizziness Hypotension Hypertension

Cough, flushing, chest tightness

Mylesuppression eg, lymphophaenia, leukopenia,

anaemia, thrombocytopenia Infusion reactions (may be fatal )

Decreased IgG mucocutaneous reactions (may be fatal )

Cardiac arrhythmias

Hepatic failure

Discontinue if severe infusion or mucocutaneous reactions occur ( eg. hypoxia, pulmonary infiltrates

Acute respiratory stress disorder, MI ventricular fibrillation ,

cardiogenic shock , Steven-Johnson Syndrome,

toxic epidermal necrolysis Tumor lysis syndrome ( specialy with tumor burden )

Monitor for renal toxicity, fluid balance, elcetrolyte abnormalites ( correct if occurs )

Pre-existing cardiovascular disease- monitor during and after treatment

Tumor infiltration High circulating malignant cells

Hepatitis B reactivation with fulminant hepatitis may occur

Monitor for signs of active HBV infection, discontinue if occurs

History of recurring , chronic infection

Severely immunocopromised eg hypogamalobunaemia

Monitor CBC, platelet counts during treatment, then periodically

Elderly Pregnancy Lactation

Indication-

Relapsed or chemoresistent stage III- IV folicullar lymphoma

Dosage-

Given im infusion initially at the rate of 50mg/hr ,

May increase infusion rate in 50mg/increments every 30 minutes to a max of 400mg/hr if infusion reactions do not occur

Use contraindicated. Observe caution