How do you dose chemotherapy (R-EPOCH or R-CHOP) in patients with aggressive lymphoma involving liver leading to elevated bilirubin and liver enzymes?  

For patients with newly diagnosed diffuse large B-cell lymphoma presenting with hyperbilirubinemia due either to liver disease or extrinsic compression, I will most often consider a pre-phase treatment either with rituximab, cyclophosphamide, or prednisone (all of which can be safely administered in...