The most commonly used regimens are:
Bendamustine-rituximab (BR)
This regimen consists of intravenous bendamustine on days 1 and 2 of each cycle, with rituximab also given on day one. The treatment is repeated every four weeks (a ‘cycle’) 4-6 times. The dose of bendamustine is adjusted according to age and kidney function. If the IgM level is high, the rituximab may be delayed until it has come down somewhat. This is because the rituximab can cause the IgM to increase at first (called IgM flare).
DRC
This regimen consists of intravenous dexamethasone on day 1, intravenous rituximab on day 1, and oral cyclophosphamide twice daily for the first five days (days 1-5). This is repeated every 21 days (a ‘cycle’) for a total of six courses.
Single-agent rituximab
This regimen consists of intravenous rituximab every week, usually for four doses. This may be repeated after three months.