Özet:

Non-Hodgkin Lymphoma (NHL) is the most common hematological malignancy. Diffuse Large B-Cell Lymphoma (DLBCL) is the most common histological type and the prognosis is variable. Rituximab+CHOP constitutes the standard treatment. Intravenous rituximab (IV Rtx) dosing has a long infusion time (90 minutes to 5-8 hours), while subcutaneous rituximab administration with the same efficacy is between 5-7 minutes. Our aim is to retrospectively evaluate the demographic characteristics, clinical findings, treatment responses, side effects, if any, and patient satisfaction of our patients with DLBCL or follicular lymphoma using subcutaneous Rtx after IV Rtx, and compare them with a small number of real-life data. Who were followed up and treated in ESOGÜTF Hematology Department, diagnosed with DLBCL or follicular lymphoma, and received SC Rtx after at least 1 dose of IV Rtx between January 2018-June 2021 28 patients were included in the study. Demographic features, clinical findings, treatment responses, side effects, if any, and patient satisfaction were recorded. Sixteen (57%) of 28 patients were male, with a mean age of 53.8±13.5 (26-78) years. While 19 (68%) patients were diagnosed with DLBCL, 9 (32%) patients were diagnosed with follicular lymphoma. 22 patients received R-CHOP, 3 patients R-COP, 3 patients R-Bendamustine treatment. Premedication was administered to all patients before both IV and subcutaneous Rtx. Neutropenia was not observed in 4 patients. Neutropenia developed after IV Rtx in 17 patients (60.7%), after SC Rtx in 4 (14.3%) patients, and after both IV and SC Rtx in 3 (10.7%) patients. No infusion-related reaction developed in any patient receiving IV Rtx. Grade 3-4 ARR did not develop in patients who received subcutaneous Rtx. As a local reaction, no side effects were observed except redness, mild edema and pain at the injection site. The mean dose of IV Rtx was 685.2±63.5 (580±790) mg, the number of SC Rtx administered was 3.53±1.37 (1-5) doses on a patient basis, and the follow-up period of the patients was 20±8.2 (7-39) months. There was no difference in efficacy and side effects when BSA was classified as low, medium and high (p>0.05). Rituximab is standard therapy for the treatment of CD20-positive B-cell lymphoma. The administration of SC rituximab, which has the same efficacy as IV Rtx, takes 5-7 minutes, provides an easier way of administration, shortens the time of application in the clinic, increases patient satisfaction and reduces the costs associated with the hospital stay. There was no difference in terms of side effects and efficacy with fixed dose SC Rtx in those with low, medium and high body surface area (BSA). No side effects were observed in any of the patients except for the local reaction related to SC Rtx. All of the patients were satisfied with the use of SC Rtx due to comfortable drug administration, less emotional distress, less injection pain and more effect on daily life activities, most importantly time saving. In conclusion, SC Rtx provides time saving, ease of application, patient satisfaction, drug administration comfort in terms of both physicians, patients and nurses applying the treatment, as well as showing efficacy and safety like the IV form.

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