B cell repopulation and when to re-administer Rituxan?

[Palmyra]

Just wondering if any of you had opinions from the experts on when to re-administer Rituxan, if B cells are repopulating, and some worrisome symptoms are creating some 'back ground noise'.

My daughter has been on RTX since original diagnosis in 2006. Her first 3 infusions were four infusions, over 4 weeks, and resulted in a drug induced remission of a year or longer.

This most recent (Feb/March of 2011) was two infusions at higher dose, at two week intervals, and she is currently showing B cell repopulation.

I don't really know what to read into this, but don't want her going into a full fledged flare.

Any opinions would be appreciated.

Palmyra Jane

[drz]

I think you find a variance in opinions on this issue like many others. My treating rheumatologist said his philosophy is not to use RTX for me unless I have a real serous flare that can't be handled other wise. He does not want to use it as a preventative measure for me. My last flare was handled successfully by increasing azathioprine and adding nasal steroids and lots of antibiotics. Other doctors like to use RTX as a maintenance measure. This same debate is also going on in treating cancer patients where it is also used and there is no research yet to prove either method is superior.

[Sangye]

Palmyra, I asked Dr Seo about all this at my last appt. See this link (page 3) for his comments
Questions for Dr Seo