Do you offer maintenance rituximab in transplant ineligible patients with mantle cell lymphoma?

The data on the role of rituximab maintenance therapy in transplant ineligible patients with mantle cell lymphoma are not straightforward to interpret. The most often cited experience (Kluin-Nelemans, et al., PMID 22873532) is a complicated study with two randomizations: induction therapy was either R-CHOP or R-FC and those achieving remission were randomized to maintenance therapy with interferon-alfa or rituximab. Because patients getting R-FC induction often had persistent myelosuppression, many were not eligible for the maintenance randomization. The subset that was randomized got much longer treatment with rituximab because of interferon toxicities. And within this selected group of patients, those who received R-CHOP induction therapy...