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Step A: Patient Selection and Eligibility
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Step B: Bio-distribution/ Diagnostic scan
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Day 1
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| Acetaminophen 650 mg and diphenhydramine 50 mg, 30 minutes prior to infusion |
| Unlabeled rituximab infusion (250 mg/m2) at a rate of at a rate of 50mg/hr, incremental to 400mg/hr |
| 5 mCi or 185 MBq/1.6 mg antibody (10 mL) of 111In-Zevalin slow intravenous injection over 10 minutes; administered within 4 hours of the cold antibody infusion |
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Days 2-6
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| Whole body planar images obtained at 48-72 hours (subsequent scanning optional) |
| Previously, images at 2-24, 48-72, and 90-120 hours |
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Step C: Dose Calculation
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| Assess the bio-distribution and if acceptable, determine the dose (0.4 or 0.3 mCi/kg based on platelet counts) |
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Step D: Therapeutic Dose Administration
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Day 7/8/9: (exact timing depends on dose arrival and logistics)
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| Acetaminophen 650 mg and diphenhydramine 50 mg, 30 minutes prior to infusion |
| Unlabeled rituximab infusion (250 mg/m2) at a rate of at a rate of 50mg/hr |
| Calculated dose of Zevalin slow IV infusion over 10 minutes through a low protein binding millipore filter (maximum dose 32 mCi or 1184 MBq); administered within 4 hours of the cold antibody infusion |
| Flush the catheter post infusion to administer complete dose |
| Assay the administration tubing set |
