Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin's lymphoma

A. D. Zelenetz, P. Hamlin, T. Kewalramani, J. Yahalom, Stephen D Nimer, Craig Moskowitz

Research output: Contribution to journalArticle

80 Citations (Scopus)

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.

Original languageEnglish
JournalAnnals of Oncology
Volume14
Issue numberSUPPL. 1
StatePublished - Jun 23 2003
Externally publishedYes

Fingerprint

Ifosfamide
Carboplatin
Etoposide
Non-Hodgkin's Lymphoma
Stem Cell Transplantation
Drug Therapy
Hematopoietic Stem Cell Mobilization
Therapeutics
Lymphoma, Large B-Cell, Diffuse
Radio
Stem Cells
Clinical Trials
Survival
Incidence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin's lymphoma. / Zelenetz, A. D.; Hamlin, P.; Kewalramani, T.; Yahalom, J.; Nimer, Stephen D; Moskowitz, Craig.

In: Annals of Oncology, Vol. 14, No. SUPPL. 1, 23.06.2003.

Research output: Contribution to journalArticle

@article{888d2a46c12b41a4b093a232725b0038,
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.",
author = "Zelenetz, {A. D.} and P. Hamlin and T. Kewalramani and J. Yahalom and Nimer, {Stephen D} and Craig Moskowitz",
year = "2003",
month = "6",
day = "23",
language = "English",
volume = "14",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "SUPPL. 1",

}

TY - JOUR

T1 - Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin's lymphoma

AU - Zelenetz, A. D.

AU - Hamlin, P.

AU - Kewalramani, T.

AU - Yahalom, J.

AU - Nimer, Stephen D

AU - Moskowitz, Craig

PY - 2003/6/23

Y1 - 2003/6/23

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0038511354&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038511354&partnerID=8YFLogxK

M3 - Article

C2 - 12736224

AN - SCOPUS:0038511354

VL - 14

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - SUPPL. 1

ER -