Administration

• Outpatient regimen.

• Consider sperm banking in males.

• Add allopurinol 300mg/d throughout first treatment cycle.

• Antiemetic therapy for moderately emetogenic regimen.

• Administer rituximab after first dose of prednisolone on day 1 before administering chemotherapy.

• Premedication with paracetamol and chlorpheniramine should be administered before each rituximab infusion.

• Monitor closely for cytokine release syndrome: fever, chills, rigors within first 2 hours usually.

• Less common side effects include: flushing, angioedema, nausea, urticaria/rash, fatigue, headache, throat irritation, rhinitis, vomiting, tumour pain and features of tumour lysis syndrome, bronchospasm, hypotension.

• Interrupt rituximab infusion if severe dyspnoea, bronchospasm or hypoxia.

• Consider doxorubicin dose reduction if significant liver impairment.

• Repeat treatment when WBC>3.0 X 109 L and platelets >100 X 109/L.

• Treat to complete remission + 2 cycles, max 8 cycles.

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