ASH Clinical News November 2016 | Page 35

CLINICAL NEWS with a subsequent biopsy negative for HL then received 30 Gy ISRT (the recommended standard radiation therapy for HL patients per the International Lymphoma Radiation Oncology Group and the National Comprehensive Cancer Network). Those with a positive PET result and positive biopsy for lympho- ma were subsequently treated off study. Twenty-nine patients received BV + AVD; 25 of these patients received the additional treatment of 30.6 Gy ISRT in 17 daily fractions. Of the four patients who did not receive ISRT, two had biopsy-confirmed refractory classic HL, one elected to come off study to receive proton beam radiotherapy to the mantle field, and one elected to come off study to receive chemotherapy alone with two additional cycles of ABVD after four cycles of brentuximab vedotin plus AVD. Adverse events (AEs) associated with BV + AVD, with or without ISRT, were generally grade 1-2 toxicities and “easily managed,” the authors noted. The most common grade ≥3 AE associated with BV + AVD was neutropenia (n=16; 53%), and peripheral neuropathy was observed in 40 percent of patients (n=12). Serious AEs occurred in six patients receiving BV + AVD, s Infusion of FEIBA should not exceed a dose of 100 units per kg body weight every 6 hours and daily doses of 200 units per kg body weight Maximum injection or infusion rate must not exceed 2 units per kg of body weight per minute. Monitor patients receiving more than 100 units per kg of body weight of FEIBA for the development of DIC, acute coronary ischemia and signs and symptoms of other thromboembolic events. If clinical signs or symptoms occur, such as chest pain or pressure, shortness of breath, altered consciousness, vision, or speech, limb or abdomen swelling and/or pain, discontinue the infusion and initiate appropriate diagnostic and therapeutic measures. Hypersensitivity and allergic reactions, including severe anaphylactoid reactions, can occur following the infusion of FEIBA. The symptoms include urticaria, angioedema, gastrointestinal manifestations, bronchospasm, and hypotension. These reactions can be severe and systemic (e.g., anaphylaxis with urticaria and angioedema, bronchospasm, and circulatory shock). Other infusion reactions, such as chills, pyrexia, and hypertension have also been reported. If signs and symptoms of severe allergic reactions occur, immediately discontinue administration of FEIBA and provide appropriate supportive care. Because FEIBA is made from human plasma it may carry a risk of transmitting infectious agents, e.g., viruses, the variant Creutzfeldt‐Jakob disease (vCJD) agent and, theoretically, the Creutzfeldt‐Jakob disease (CJD) agent. The most frequently reported adverse reactions observed in >5% of subjects in the prophylaxis trial were anemia, diarrhea, hemarthrosis, hepatitis B surface antibody positive, nausea, and vomiting. The serious adverse reactions seen with FEIBA are hypersensitivity reac tions and thromboembolic events, including stroke, pulmonary embolism and deep vein thrombosis. Use of antifibrinolytics within approximately 6 to 12 hours after the administration of FEIBA is not recommended. Please see next page for FEIBA Brief Summary of Prescribing Information. To see the Full Prescribing Information, including Boxed Warning, go to www.FEIBA.com References: 1. FEIBA Prescribing Information. Westlake Village, CA: Baxter Healthcare Corporation; November 2013. 2. Antunes SV, Tangada S, Stasyshyn O, et al. Randomized comparison of prophylaxis and ondemand regimens with FEIBA NF in the treatment of haemophilia A and B with inhibitors. Haemophilia. 2014;20(1):65-72. Baxalta and Feiba are trademarks of Baxalta Incorporated January 2016 USBS/145/15-0065 including grade 3 febrile neutropenia (n=3) and grade 1/2 fever without neutropenia (n=2). The most common acute toxicities associated with ISRT were fatigue (n=22; 88%), dermatitis (n=20), dysphagia (n=20), and esophagitis (n=13). No clinically significant, drug-related pulmonary toxicity