Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin's lymphoma Journal Article
| Authors: | Zelenetz, A. D.; Hamlin, P.; Kewalramani, T.; Yahalom, J.; Nimer, S.; Moskowitz, C. H. |
| Article Title: | Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin's lymphoma |
| Abstract: | Despite advances in the management of aggressive non-Hodgkin's lymphoma, the treatment of relapsed and primary refractory disease remains a major challenge. High-dose chemotherapy or radio-chemotherapy followed by autologous or allogeneic stem cell transplantation (SCT) is a potentially curative treatment approach; however, the applicability of this approach is restricted to patients responding to second-line chemotherapy. Thus, second-line therapy must be both efficacious and without stem cell or organ toxicity that would compromise the ability to proceed to SCT. The ifosfamide, carboplatin and etoposide (ICE) regimen was developed to address these challenges. In a series of prospective clinical trials, 222 patients were treated with the ICE regimen, with an overall response rate of 72%. The mobilization of stem cells with this regimen was excellent, with 86% of patients mobilizing at least 2.0 × 106 CD34+ cells/kg. The incidence of treatment-related toxicity precluding SCT after ICE is very low. Herein, we report the clinical results of this treatment program for 222 patients with 5-year median follow-up for surviving patients. Rituximab was subsequently added to the ICE regimen for patients with diffuse large B-cell lymphoma (DLBCL) to improve upon these favorable results. This resulted in an increased complete remission rate. Additional follow-up is necessary to determine if this improvement in the complete remission rate will confer an increase in the overall survival following SCT. |
| Keywords: | adolescent; adult; cancer survival; treatment outcome; aged; clinical trial; neutropenia; cancer recurrence; cisplatin; area under the curve; cancer combination chemotherapy; cytarabine; rituximab; follow up; follow-up studies; carboplatin; etoposide; antineoplastic combined chemotherapy protocols; incidence; recurrence; cyclophosphamide; dexamethasone; melphalan; stem cell transplantation; carmustine; ifosfamide; health program; b cell lymphoma; cancer regression; nonhodgkin lymphoma; lymphoma, non-hodgkin; drug response; mitoxantrone; stem cell mobilization; large cell lymphoma; mesna; recombinant granulocyte colony stimulating factor; granulocyte colony stimulating factor; meta analysis; clinical trials; humans; human; male; female; priority journal; article |
| Journal Title: | Annals of Oncology |
| Volume: | 14 |
| Issue: | Suppl.1 |
| ISSN: | 0923-7534 |
| Publisher: | Oxford University Press |
| Date Published: | 2003-01-01 |
| Start Page: | i5 |
| End Page: | i10 |
| Language: | English |
| PUBMED: | 12736224 |
| PROVIDER: | scopus |
| DOI: | 10.1093/annonc/mdg702 |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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