Ifosfamide, carboplatin, and etoposide

A highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant- eligible patients with non-Hodgkin's lymphoma

Craig Moskowitz, Joseph R. Bertino, Jill R. Glassman, Eric E. Hedrick, Sonia Hunte, Nancy Coady-Lyons, David B. Agus, Andre Goy, Joseph Jurcic, Ariela Noy, James O'Brien, Carol S. Portlock, David S. Straus, Barrett Childs, Richard Frank, Joachim Yahalom, Daniel Filippa, Diane Louie, Stephen D Nimer, Andrew D. Zelenetz

Research output: Contribution to journalArticle

251 Citations (Scopus)

Abstract

Purpose: To evaluate a chemotherapy regimen that consisted of ifosfamide administered as an infusion with bolus carboplatin, and etoposide (ICE) supported by granuloctye colony-stimulating factor (G-CSF) for cytoreduction and stem-cell mobilization in transplant-eligible patients with primary refractory or relapsed non-Hodgkin's lymphoma (NHL). Patients and Methods: One hundred sixty-three transplant-eligible patients with relapsed or primary refractory NHL were treated from October 1993 to December 1997 with ICE chemotherapy at Memorial Sloan-Kettering Cancer Center. Administration of three cycles of ICE chemotherapy was planned at 2-week intervals. Peripheral- blood progenitor cells were collected after cycle 3, and all patients who achieved a partial response (PR) or complete response (CR) to ICE chemotherapy were eligible to proceed to transplantation. Event-free and overall survival, ICE-related toxicity, and the number of CD34+ cells collected after treatment with ICE and G-CSF were evaluated. Results: All 163 patients were assessable for response, and there was no treatment-related mortality. A major response (CR/PR) was evident in 108 patients (66.3%); 89% of the responding patients underwent successful transplantation. Patient who underwent transplantation and achieved a CR to ICE had a superior overall survival to that of patients who achieved a PR (65% v30%; P = .003). The median number of CD34+ cells/kg collected was 8.4 :< 106. The dose-limiting toxicity of ICE was hematologic, with 29.4% of patients developing grade 3/4 thrombocytopenia. There were minimal nonhematologic side effects. Conclusion: ICE chemotherapy, with ifosfamide administered as a 24-hour infusion to decrease CNS side effects, and the substitution of carboplatin for cisplatin to minimize nephrotoxicity, is a very effective cytoreduction and mobilization regimen in patients with NHL. Furthermore, the quality of the clinical response to ICE predicts for posttransplant outcome.

Original languageEnglish
Pages (from-to)3776-3785
Number of pages10
JournalJournal of Clinical Oncology
Volume17
Issue number12
StatePublished - Dec 1 1999
Externally publishedYes

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Ifosfamide
Carboplatin
Etoposide
Non-Hodgkin's Lymphoma
Blood Cells
Stem Cells
Transplants
Drug Therapy
Colony-Stimulating Factors
Transplantation
Cell Count
Hematopoietic Stem Cell Mobilization
Cisplatin
Disease-Free Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ifosfamide, carboplatin, and etoposide : A highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant- eligible patients with non-Hodgkin's lymphoma. / Moskowitz, Craig; Bertino, Joseph R.; Glassman, Jill R.; Hedrick, Eric E.; Hunte, Sonia; Coady-Lyons, Nancy; Agus, David B.; Goy, Andre; Jurcic, Joseph; Noy, Ariela; O'Brien, James; Portlock, Carol S.; Straus, David S.; Childs, Barrett; Frank, Richard; Yahalom, Joachim; Filippa, Daniel; Louie, Diane; Nimer, Stephen D; Zelenetz, Andrew D.

In: Journal of Clinical Oncology, Vol. 17, No. 12, 01.12.1999, p. 3776-3785.

Research output: Contribution to journalArticle

Moskowitz, C, Bertino, JR, Glassman, JR, Hedrick, EE, Hunte, S, Coady-Lyons, N, Agus, DB, Goy, A, Jurcic, J, Noy, A, O'Brien, J, Portlock, CS, Straus, DS, Childs, B, Frank, R, Yahalom, J, Filippa, D, Louie, D, Nimer, SD & Zelenetz, AD 1999, 'Ifosfamide, carboplatin, and etoposide: A highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant- eligible patients with non-Hodgkin's lymphoma', Journal of Clinical Oncology, vol. 17, no. 12, pp. 3776-3785.
Moskowitz, Craig ; Bertino, Joseph R. ; Glassman, Jill R. ; Hedrick, Eric E. ; Hunte, Sonia ; Coady-Lyons, Nancy ; Agus, David B. ; Goy, Andre ; Jurcic, Joseph ; Noy, Ariela ; O'Brien, James ; Portlock, Carol S. ; Straus, David S. ; Childs, Barrett ; Frank, Richard ; Yahalom, Joachim ; Filippa, Daniel ; Louie, Diane ; Nimer, Stephen D ; Zelenetz, Andrew D. / Ifosfamide, carboplatin, and etoposide : A highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant- eligible patients with non-Hodgkin's lymphoma. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 12. pp. 3776-3785.
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abstract = "Purpose: To evaluate a chemotherapy regimen that consisted of ifosfamide administered as an infusion with bolus carboplatin, and etoposide (ICE) supported by granuloctye colony-stimulating factor (G-CSF) for cytoreduction and stem-cell mobilization in transplant-eligible patients with primary refractory or relapsed non-Hodgkin's lymphoma (NHL). Patients and Methods: One hundred sixty-three transplant-eligible patients with relapsed or primary refractory NHL were treated from October 1993 to December 1997 with ICE chemotherapy at Memorial Sloan-Kettering Cancer Center. Administration of three cycles of ICE chemotherapy was planned at 2-week intervals. Peripheral- blood progenitor cells were collected after cycle 3, and all patients who achieved a partial response (PR) or complete response (CR) to ICE chemotherapy were eligible to proceed to transplantation. Event-free and overall survival, ICE-related toxicity, and the number of CD34+ cells collected after treatment with ICE and G-CSF were evaluated. Results: All 163 patients were assessable for response, and there was no treatment-related mortality. A major response (CR/PR) was evident in 108 patients (66.3{\%}); 89{\%} of the responding patients underwent successful transplantation. Patient who underwent transplantation and achieved a CR to ICE had a superior overall survival to that of patients who achieved a PR (65{\%} v30{\%}; P = .003). The median number of CD34+ cells/kg collected was 8.4 :< 106. The dose-limiting toxicity of ICE was hematologic, with 29.4{\%} of patients developing grade 3/4 thrombocytopenia. There were minimal nonhematologic side effects. Conclusion: ICE chemotherapy, with ifosfamide administered as a 24-hour infusion to decrease CNS side effects, and the substitution of carboplatin for cisplatin to minimize nephrotoxicity, is a very effective cytoreduction and mobilization regimen in patients with NHL. Furthermore, the quality of the clinical response to ICE predicts for posttransplant outcome.",
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T1 - Ifosfamide, carboplatin, and etoposide

T2 - A highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant- eligible patients with non-Hodgkin's lymphoma

AU - Moskowitz, Craig

AU - Bertino, Joseph R.

AU - Glassman, Jill R.

AU - Hedrick, Eric E.

AU - Hunte, Sonia

AU - Coady-Lyons, Nancy

AU - Agus, David B.

AU - Goy, Andre

AU - Jurcic, Joseph

AU - Noy, Ariela

AU - O'Brien, James

AU - Portlock, Carol S.

AU - Straus, David S.

AU - Childs, Barrett

AU - Frank, Richard

AU - Yahalom, Joachim

AU - Filippa, Daniel

AU - Louie, Diane

AU - Nimer, Stephen D

AU - Zelenetz, Andrew D.

PY - 1999/12/1

Y1 - 1999/12/1

N2 - Purpose: To evaluate a chemotherapy regimen that consisted of ifosfamide administered as an infusion with bolus carboplatin, and etoposide (ICE) supported by granuloctye colony-stimulating factor (G-CSF) for cytoreduction and stem-cell mobilization in transplant-eligible patients with primary refractory or relapsed non-Hodgkin's lymphoma (NHL). Patients and Methods: One hundred sixty-three transplant-eligible patients with relapsed or primary refractory NHL were treated from October 1993 to December 1997 with ICE chemotherapy at Memorial Sloan-Kettering Cancer Center. Administration of three cycles of ICE chemotherapy was planned at 2-week intervals. Peripheral- blood progenitor cells were collected after cycle 3, and all patients who achieved a partial response (PR) or complete response (CR) to ICE chemotherapy were eligible to proceed to transplantation. Event-free and overall survival, ICE-related toxicity, and the number of CD34+ cells collected after treatment with ICE and G-CSF were evaluated. Results: All 163 patients were assessable for response, and there was no treatment-related mortality. A major response (CR/PR) was evident in 108 patients (66.3%); 89% of the responding patients underwent successful transplantation. Patient who underwent transplantation and achieved a CR to ICE had a superior overall survival to that of patients who achieved a PR (65% v30%; P = .003). The median number of CD34+ cells/kg collected was 8.4 :< 106. The dose-limiting toxicity of ICE was hematologic, with 29.4% of patients developing grade 3/4 thrombocytopenia. There were minimal nonhematologic side effects. Conclusion: ICE chemotherapy, with ifosfamide administered as a 24-hour infusion to decrease CNS side effects, and the substitution of carboplatin for cisplatin to minimize nephrotoxicity, is a very effective cytoreduction and mobilization regimen in patients with NHL. Furthermore, the quality of the clinical response to ICE predicts for posttransplant outcome.

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