Other oncology nurses have mentioned to me that they infuse rituximab (Rituxan) over 90 minutes. Are there references for this? — Ruth C. Gholz, RN, MS, AOCN, and colleagues at the Cincinnati VA Medical Center

The 5- to 6-hour infusion time utilized for rituximab has stimulated research into safely speeding up the infusion. One study involved 1,200 patients with only one Grade 3 reaction when rituximab was administered over 90 minutes (Blood. 2007;109:4171-4173). Another study reported successful administration in 60 minutes without significant reactions (Ann Oncol. 2006;17:1027-1028). Before attempting more rapid infusions of rituximab, strict safety monitoring algorithms should be established. Temperature, blood pressure, and heart and respiratory rates should be measured before the infusion and again at 15, 30, 60, and 90 minutes; and the patient questioned about adverse experiences. — Donald Fleming, MD