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

Purpose
The care of oncology patients is complex, requiring multidisciplinary support. Due to the complex nature of these patients, a pilot project was implemented to assess the value of a clinic based pharmacist to support solid tumor patients.  


Methods
For a three-week period, a PGY-2 hematology/oncology pharmacy resident was embedded into the medical oncology clinic space. During this time the resident provided patient education, worked with the oncology providers, and developed quality improvement projects. Patient education was provided to all solid tumor patients prior to the start of their first cycle and follow up calls were made about 1 week after chemotherapy. All interventions were tracked within the patient chart, and categorized as patient education, drug information, medication error, toxicity management, medication reconciliation, or chemotherapy adjustment. Interventions were then examined and based on previously published data, cost value associations were assigned to each to determine a return on investment. In addition, the resident met with physicians to discuss quality improvement projects that a pharmacist could assist with or champion.
 
Results
During the pilot period 160 pharmacist interventions were made. Of these 160 interventions, 39 separate patient educations were completed, 34 chemotherapy regimens were adjusted, 17 chemotherapy toxicities were managed, 29 medication reconciliations were completed, and 35 drug information questions were answered, 13 of which were related to antimicrobial stewardship. For the 160 interventions made over the course of the 3 weeks, cost savings were estimated to be $76,976. This results in an estimated annualized cost savins of $1,334,651. Two quality improvement projects were identified, one focused on developing a standardized pathway for prescribing bone modifying agents and a second focused on patient education.  


Conclusion 
The addition of a clinical pharmacist in solid tumor clinics offers both cost savings and improved quality of care. These savings can offset the added FTE while providing enhanced clinical support to providers, improving patient satisfaction, and driving ongoing advancements in patient care. 

Purpose 
The purpose of this retrospective review is to compare hematologic and iron-related responses between traditional 1000 mg iron courses, and high dose courses. The goal is to inform optimal dosing strategies and maximize clinical outcomes.
Methods 
This single center, retrospective study evaluated patients who received IV iron between January 1st 2024 and December 31st 2024 at Thomas Jefferson University. Patients were divided into two arms based on total IV iron dose: 1000 mg or 1500 mg. Exclusion criteria was applied removing comorbidities and incomplete records, with final patients case-control matched on: ferritin, baseline hemoglobin (hgb), age, and gender. The primary outcome was mean change in hgb from baseline to between 4-52 weeks post infusion. Secondary outcomes included changes in relevant iron labs (ferritin, transferrin saturation (TSAT), total iron binding capacity (TIBC), iron, and hematocrit (Hct)) and regression analysis of variable associated with change in hgb greater than the 25th percentile (>P25).  


Results 
From 3,508 patients, 591 met eligibility after exclusions. A random sample of 300 patients (150 per arm) were chart reviewed, with exclusions for missing data yielding 213. After matching 166 patients, 83 in each arm, were used for analysis.  IV iron formulation was the significant demographic, with 76 vs 0 receiving ferric carboxymaltose in 1500 mg vs 1000 mg arms respectively. Mean Hgb increased by 3.4 vs 2.7 g/dL (p=0.002) in the 1500 mg vs 1000 mg arms respectively. Greater improvements in Hct, iron, TSAT, TIBC, and ferritin (p<0.01), were