Effects of Supervised Exercise Program on Rituximab Induced Lung Toxicity in Follicular Lymphoma - A Case Report

Rituximab when given along with standard chemotherapy, standard line of treatment for follicular lymphoma (FL), may develop Rituximab induced lung toxicity (RILT). We present a case study of a 36 years old male diagnosed with FL who underwent 3 cycles of chemotherapy along with Rituximab. During treatment, he developed recurrent lower respiratory tract infection for which he received antibiotic and antifungal drugs. Patient was referred to physiotherapy department for Pulmonary Rehabilitation in view of significant dyspnoea. Baseline assessment of functional capacity done using Six Minutes’ Walk Test (6MWT) and dyspnoea using Cancer Dyspnoea Scale (CDS) and supervised exercise program (SEP) was developed. The recommendation was for a 6-week multimodal SEP which included, breathing exercises using a Positive End Expiratory Pressure (PEP) device like bottle PEP, Aerobic exercises and Strengthening exercises. Patient was evaluated after 3 and 6 weeks. There was a significant improvement in 6MWTdistance and CDS score along with increase duration of expiration while doing Bottle PEP exercises. SEP is safe and feasible to improve the respiratory health in patient subjected to RILT in FL. Key words: Supervised exercise program, rituximab induced lung toxicity, follicular lymphoma