Would you consider re-challenging a patient with rituximab after they experienced delayed neutropenia?

This is an important question as rituximab is a key treatment option across multiple rheumatic conditions. Probably the best study to inform this question comes from Zonozi et al., PMID 32892495 who retrospectively studied 738 RTX-treated patients at a single institution. They found that late-onset ...

3% of patients treated with Rituxan may have delayed neutropenia. I would not re-challenge them with Rituxan and would consider giving the Neupogen to raise the patient's WBC count if it was too low.