ASH Clinical News November 2016 | Page 3

RELAPSED OR REFRACTORY FOLLICULAR LYMPHOMA For the treatment of patients with follicular lymphoma who relapsed after, or are refractory to, a rituximab-containing regimen CHOOSE GAZYVA PLUS BENDAMUSTINE FOLLOWED BY GAZYVA MONOTHERAPY1 IMPORTANT SAFETY INFORMATION (CONT’D) Infections • Serious bacterial, fungal, and new or reactivated viral infections can occur during and following GAZYVA therapy. Fatal infections have been reported with GAZYVA. Do not administer GAZYVA to patients with an active infection. Patients with a history of recurring or chronic infections may be at increased risk of infection Neutropenia • Severe and life-threatening neutropenia, including febrile neutropenia, has been reported during treatment with GAZYVA. Patients with Grade 3 to 4 neutropenia should be monitored frequently with regular laboratory tests until resolution. Anticipate, evaluate, and treat any symptoms or signs of developing infection. Consider administration of granulocyte colony-stimulating factors (G-CSF) in patients with Grade 3 or 4 neutropenia • Neutropenia can also be of late onset (occurring more than 28 days after completion of treatment) and/or prolonged (lasting longer than 28 days) • Consider dose delays in the case of Grade 3 or 4 neutropenia. Patients with severe and long lasting (>1 week) neutropenia are strongly recommended to receive antimicrobial prophylaxis until resolution of neutropenia to Grade 1 or 2. Antiviral and antifungal prophylaxis should be considered Thrombocytopenia • Severe and life threatening thrombocytopenia has been reported during treatment with GAZYVA in combination with bendamustine. Monitor all patients frequently for thrombocytopenia and hemorrhagic events, especially during the first cycle. In patients with Grade 3 or 4 thrombocytopenia, monitor platelet counts more frequently until resolution and consider subsequent dose delays of GAZYVA and bendamustine or dose reductions of bendamustine. Transfusion of blood products (ie, platelet transfusion) may be necessary. Consider withholding concomitant medications which may increase bleeding risk (eg, platelet inhibitors or anticoagulants), especially during the first cycle Immunization • The safety and efficacy of immunization with live or attenuated viral vaccines during or following GAZYVA therapy have not been studied. Immunization with live virus vaccines is not recommended during treatment and until B-cell recovery