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Despite ad varices in treatment, including the introduction of rituximab, survival after diffuse large B-cell lymphoma (DLBCL) remains heterogeneous. However, no studies have considered the association between neighborhood socioeconomic status (SES) and race/ ethnicity on DLBCL mortality before (1988-2000) and after (2001-2009) the introduction of rituximab. We studied all 33 032 DLBCL patients diagnosed between 1988-2009 in California for vital status through December 31,2010. Patients diagnosed from 2001 to 2009 vs 1988 to 2000 had significantly decreased overall and DLBCL-specific mortality. However, those living in lower SES neighborhoods had 34% (95% confidence interval [CI], 27%-40%) and 24% (95% CI, 16%-32%) higher mortality rate from all causes and lymphoma, respectively, than patients in higher SES neighborhoods. The magnitude of mortality disparities by neighborhood SES was more marked in younger (<65 years) than in older patients (⩾65 years), in married than nonmarried patients, and after 2000. We concluded that patients living in low SES neighborhoods had substantially worse survival after DLBCL, and this disparity was striking in younger (ie, not eligible for Medicare-aged) patients, married patients, and after the introduction of rituximab. These disparities suggest there are barriers, including inadequate insurance coverage with additional financial burden, to effective treatment among socioeconomically disadvantaged patients. [ABSTRACT FROM AUTHOR]

Purpose: To determine the feasibility of dose-rounding rituximab by looking at the potential deviation from the prescribed dose to the dose rounded to the nearest vial size. Methods: This study is a retrospective chart review of all rituximab orders prescribed for hematologic or oncologic indications over a period of 24 months. The feasibility of dose-rounding rituximab to the nearest vial size was evaluated by looking at the potential deviation of the prescribed dose to the rounded dose. Physician opinion towards dose rounding rituximab was assessed through a survey. Results: From October 2008 through September 2010, 2028 orders of rituximab were prescribed and processed. Ninety-nine percent of all rituximab doses fell within 10% dose deviation if rounded to the nearest 100-mg vial size and 66.1% of all rituximab orders fell within 5% dose deviation. All responding physicians were comfortable with at least a 5% dose deviation, projecting a yearly savings of approximately US$37,000 through rounding down and capturing additional cost of approximately US$43,000 through rounding up. Conclusion: The projected savings of dose-rounding rituximab to the nearest vial size resulted in both substantial financial savings and reduced unnecessary wastage of unused drug. [ABSTRACT FROM AUTHOR]