Radioimmunotherapy with tositumomab and iodine-131 tositumomab for low-grade non-Hodgkin lymphoma: nursing implications.

PURPOSE/OBJECTIVES To review radioimmunotherapy approaches for low-grade non-Hodgkin lymphoma (NHL) with a focus on tositumomab and iodine-131 tositumomab (Bexxar, Corixa Corporation, Seattle, WA, and GlaxoSmithKline, Philadelphia, PA). Nursing implications for Bexxar therapy are reviewed, including radiation safety, patient education, and the management of therapy-related toxicities. DATA SOURCES Journal articles, published research data, and clinical experience. DATA SYNTHESIS The Bexxar treatment regimen (using an anti-CD20 antibody) consists of a dosimetric administration followed 7-14 days later by a patient-specific therapeutic administration. Infusion-related adverse events and myelosuppression are manageable. Patient and caregiver education regarding the benefits of radioimmunotherapy, treatment protocols, and radiation safety precautions is necessary. CONCLUSIONS Bexxar therapy represents an important new treatment option for patients with low-grade NHL and can be administered on an outpatient basis. IMPLICATIONS FOR NURSING Nurses play a vital role in the success of a Bexxar therapy program by providing patient and caregiver education, patient monitoring, and coordinating treatment schedules.