For inpatient treatment of lymphoma and ALL, can rituximab be delayed?
I.e., Can day 2 Rituximab (RCHOP) or day 6 Rituximab (DA-EPOCH, Hyper CVAD) be given? Or should only Day 1 Rituximab be used with chemoimmunotherapy in lymphoma and ALL? Our hospital prefers outpatient Rituximab due to the cost.
Answer from: Medical Oncologist at Academic Institution
Although I am not aware of published data on this issue, at least for patient receiving DA-R-EPOCH, I have learned that it is common practice to delay the day 1 rituximab because of the reimbursement issue you refer to. I don't think the effect of this has been studies systematically, but i'm not aw...
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Answer from: Medical Oncologist at Community Practice
I have commonly delayed the rituximab. Some patients have severe reactions on starting the rituximab presumably due to cytokine release by sensitive tumor cells. I then immediately stop and give the therapy at the end of CHOP and find that the reaction does not occur since considerable tumor death h...