For inpatient treatment of lymphoma and ALL, can rituximab be delayed?

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...

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...