@deleder2k --
Here's what I envision might be a good strategy for an ME patient once we know that Rituximab is effective:
1) Get a year's worth of Rituximab using the same schedule as is being used in the big phase 3 trial. That year of infusions is probably enough -- if it weren't, they wouldn't be pursuing it.
2) After the 6th infusion (the one at the 12-month mark), stop getting any infusions and wait for a relapse to see how long you can go without more Rituximab.
3) Once you start relapsing, repeat the 12-month Rituximab cycle (assuming your first response was large enough and long enough to make Rituximab a viable long-term treatment for you).
4) Now you know how long a year's worth of Rituximab lasts you, and in the future, you can start new 12-month cycles right before you know you would start relapsing. That way, you go as long as possible without getting more Rituximab but you never relapse. That allows your good antibodies to recover and reduces the risk of major infection. I believe this is done in RA, and that the amount of time before relapse tends to be the same for an individual patient after each course of Rituximab.
The only layer of complexity I might add is that if your symptoms are still improving at the time of the 6th infusion at 12 months -- in other words, if your response hasn't stabilized -- maybe it might make sense to get one or two more infusions at 15 and 18 months. In RA, I believe the experience has been that the longer you keep the patient without b-cells, the greater the chances of long-term remission. Unfortunately, it also increases the risk of major infection.
Goes without saying that I'm not a doctor, this isn't medical advice, wait for the phase 3 results, insert legal disclaimer here, please don't sue me.