Hello,
Welcome to the site. I hope that Gayatri is doing well. How well did she react to the rituximab? Was it effective during the two years? It is possible to repeat the Rituximab - for some people the 2nd time may bring about permanent relief. Instead getting the full course of 4, she can try just one dose of rituximab. It may be helpful to administer prednisone for a few weeks before and after the single dose of rituximab. Please discuss this with your doctor.
Best of luck,
Sharmin