PSHP 2026 Residency Conference

Purpose: The incidence of delayed infusion reactions from PV is unknown. The label recommends post-infusion monitoring for delayed infusion reactions. This study investigates the incidence and characterization of delayed infusion reactions with PV. 


Methods: This is an IRB approved, single-institution, retrospective, cohort study utilizing electronic health record data within the Penn Medicine health system. All adult patients who received a dose of PV between June 10th, 2019, and August 31st, 2025 were included for analysis. Data collected included patient and disease demographics, infusion administrations, and infusion reaction event documentation. The primary endpoint was the incidence of delayed infusion reactions occurring within 72 hours after infusion completion. Secondary endpoints include symptom characterization of delayed infusion reactions, time of onset of delayed infusion reactions, incidence and symptom characterization of all infusion reactions, and ambulatory infusion chair time. Analyses of primary and secondary endpoints were conducted using descriptive statistics. 


Results: Overall, 352 patients with lymphoma were included, and a total of 1310 infusions of PV were administered. The frequency of delayed infusion reactions was 0.5% (6/1310) of total infusions occurring in 1.4% (5/352) of total patients. Of these reactions, 33% (2/6) and 66.7% (4/6) were CTCAE grade 1 and 2, respectively. Median time to delayed reaction onset was 30 minutes (IQR 25-63). Frequency of delayed infusion reactions occurring on first infusion was 50% (3/6) and one reaction occurred each with 2nd, 3rd, and 4th doses. Median chair time for regimens consisting of first and subsequent PV administrations was 6 (IQR 4–8) and 5 (IQR 4– 6) hours respectively. 


Conclusion: To our knowledge, this is the first characterization of delayed infusion reactions to PV. We determined the incidence of delayed infusion reactions to be 0.5% out of 1310 infusions. Of those who experienced delayed reactions, all were grade 2 or lower requiring minimal intervention, and no resulting hospitalizations were reported secondary to events. Our results suggest that observation post-PV infusions may be potentially mitigated or omitted. 


Authors: Michael P. Roney, PharmD; Oxana Megherea, PharmD, BCOP; Niti Patel, PharmD, BCOP; Mitchell E. Hughes, PharmD, BCOP