Rituximab Maintenance Dilemma

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Hello all. I'm wondering if there's anyone else out there feeling anxious over whether to continue Rituximab Maintenance in light of the current Covid situation? Last week, I got my 8th treatment of 12 scheduled. My consultant has major doubts I will have had much, if any, response to the vaccine and indicated that current advice is I should delay the 3rd vaccination until 6 months out from end of treatment...that would mean mid-November 2022!! Not sure I can realistically shield until then while family, friends and the rest of the country rightly enjoy their freedom from pandemic restrictions?                                                                                                            
I'm truly lucky to live in the country and without pressure to return to the office, working from home, walking the dog, gardening, etc...but, it still feels an awfully long haul and increasingly socially isolating. It's especially tough on my amazing partner, who's facing this period of shielding too, along with my anxiety. All in all, I'm seriously tempted to quit the RM with a view to getting my 3rd Covid jab in March and then perhaps being able to relax a little and start living a more "normal" life. My research about RM makes me confident it should prolong the complete positive response I had from R-CHOP, but I'm also concerned about whether the Ritux itself will be damaging in other ways (I had frontline treatment with it following initial diagnosis, so I've had a quite a lot of this particular drug!)
It would be great to know if others are hearing the same about vaccination timings from their consultants, about RM experiences, or for any support, tips or suggestions to deal with this ongoing challenge. Many thanks!

  • Hi  and welcome to this corner of the Community although always sorry to see folks joining us. I am Mike  and I help out around our Lymphoma groups.

    I was diagnosed way back in 1999 with a rare incurable but treatable type of skin Non Hodgkin’s Lymphoma Stage 4a and although my blood cancer ‘type’ is different I have experienced most types of treatments used but not necessarily the exact same drug mix.

    I had over 750hrs of Retuximab during my main treatments but did not have maintenance but went straight to two Allo (donor) Stem Cell Transplant so can't help you with regards to your question but there are others who have been in this situation so let's look for them to pick up on your post.

    Do also check out https://lymphoma-action.org.uk/covid-19-and-lymphoma a small UK Lymphoma Specific Charity who have lots of up to date information, guidance, videos and run regular regional online Lymphoma support groups and indeed a great Lymphoma Buddy Service

    Mike (Thehighlander)

    It always seems impossible until its done - Nelson Mandela

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  • Thanks so much for your response and suggestions, Mike. I've read the guidance on Lymphoma Action and it's a great help. Keep up the good work!

  • I'm doing ritux maintenance too. There are several papers on this, a google search finds them. It seems that some ritux patients still make antibodies and even those that don't do make a T cell response. Nobody knows yet if the response is protective enough but it seems to me that it is worth getting the vaccine just in case.

  • Thanks and agreed. In fact I had 3rd jab last week + flu jab, so fingers crossed...Still keeping a low profile to be on the safe side, naturally. All the best with your treatment!

  • I'm having Obinutuzumab maintenance (very similar) and had my 3rd vaccine today. I had timed it for 2 weeks before my next maintenance, to give myself the best chance of making some antibodies before the O knocks out my B cells again!

  • Of course now we know that the intention is that we, the immunosuppressed, have a third jab now with a booster in six months, so four in total. But I imagine we'll end up getting it every year or so anyway.