Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma

Tarun Kewalramani, Andrew D. Zelenetz, Stephen D Nimer, Carol Portlock, David Straus, Ariela Noy, Owen O'Connor, Daniel A. Filippa, Julie Teruya-Feldstein, Alison Gencarelli, Jing Qin, Alyson Waxman, Joachim Yahalom, Craig Moskowitz

Research output: Contribution to journalArticle

313 Citations (Scopus)

Abstract

Patients with relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) who achieve complete response (CR) before autologous stem cell transplantation (ASCT) generally have better outcomes than those who achieve only partial response (PR). We investigated whether adding rituximab to the ifosfamide-carboplatin-etoposide (ICE) chemotherapy regimen (RICE) could increase the CR rate of patients with DLBCL under consideration for ASCT. Thirty-six eligible patients were treated with RICE, and 34 received all 3 planned cycles. The CR rate was 53%, significantly better than the 27% CR rate (P = .01) achieved among 147 similar consecutive historical control patients with DLBCL treated with ICE; the PR rate was 25%. Febrile neutropenia was the most frequent grade 3 or 4 nonhematologic toxicity; It occurred in 7.5% of delivered cycles. No patient had RICE-related toxicity that precluded ASCT. The median number of CD34+ cells per kilogram mobilized was 6.3 × 106. Progression-free survival rates of patients who underwent transplantation after RICE were marginally better than those of 95 consecutive historical control patients who underwent transplantation after ICE (54% vs 43% at 2 years; P = .25). RICE appears to induce very high CR rates in patients with relapsed and refractory DLBCL; however, further studies are necessary to determine whether this treatment regimen will improve outcomes after ASCT.

Original languageEnglish
Pages (from-to)3684-3688
Number of pages5
JournalBlood
Volume103
Issue number10
DOIs
StatePublished - May 15 2004
Externally publishedYes

Fingerprint

Ifosfamide
Lymphoma, Large B-Cell, Diffuse
Carboplatin
Stem Cell Transplantation
Etoposide
Stem cells
Refractory materials
Cells
Toxicity
Chemotherapy
Therapeutics
Transplantation
Febrile Neutropenia
Rituximab
Disease-Free Survival
Survival Rate
Cell Count
Drug Therapy

ASJC Scopus subject areas

  • Hematology

Cite this

Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma. / Kewalramani, Tarun; Zelenetz, Andrew D.; Nimer, Stephen D; Portlock, Carol; Straus, David; Noy, Ariela; O'Connor, Owen; Filippa, Daniel A.; Teruya-Feldstein, Julie; Gencarelli, Alison; Qin, Jing; Waxman, Alyson; Yahalom, Joachim; Moskowitz, Craig.

In: Blood, Vol. 103, No. 10, 15.05.2004, p. 3684-3688.

Research output: Contribution to journalArticle

Kewalramani, T, Zelenetz, AD, Nimer, SD, Portlock, C, Straus, D, Noy, A, O'Connor, O, Filippa, DA, Teruya-Feldstein, J, Gencarelli, A, Qin, J, Waxman, A, Yahalom, J & Moskowitz, C 2004, 'Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma', Blood, vol. 103, no. 10, pp. 3684-3688. https://doi.org/10.1182/blood-2003-11-3911
Kewalramani, Tarun ; Zelenetz, Andrew D. ; Nimer, Stephen D ; Portlock, Carol ; Straus, David ; Noy, Ariela ; O'Connor, Owen ; Filippa, Daniel A. ; Teruya-Feldstein, Julie ; Gencarelli, Alison ; Qin, Jing ; Waxman, Alyson ; Yahalom, Joachim ; Moskowitz, Craig. / Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma. In: Blood. 2004 ; Vol. 103, No. 10. pp. 3684-3688.
@article{149a58fb811b4b1294578f4aeefe4a00,
title = "Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma",
abstract = "Patients with relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) who achieve complete response (CR) before autologous stem cell transplantation (ASCT) generally have better outcomes than those who achieve only partial response (PR). We investigated whether adding rituximab to the ifosfamide-carboplatin-etoposide (ICE) chemotherapy regimen (RICE) could increase the CR rate of patients with DLBCL under consideration for ASCT. Thirty-six eligible patients were treated with RICE, and 34 received all 3 planned cycles. The CR rate was 53{\%}, significantly better than the 27{\%} CR rate (P = .01) achieved among 147 similar consecutive historical control patients with DLBCL treated with ICE; the PR rate was 25{\%}. Febrile neutropenia was the most frequent grade 3 or 4 nonhematologic toxicity; It occurred in 7.5{\%} of delivered cycles. No patient had RICE-related toxicity that precluded ASCT. The median number of CD34+ cells per kilogram mobilized was 6.3 × 106. Progression-free survival rates of patients who underwent transplantation after RICE were marginally better than those of 95 consecutive historical control patients who underwent transplantation after ICE (54{\%} vs 43{\%} at 2 years; P = .25). RICE appears to induce very high CR rates in patients with relapsed and refractory DLBCL; however, further studies are necessary to determine whether this treatment regimen will improve outcomes after ASCT.",
author = "Tarun Kewalramani and Zelenetz, {Andrew D.} and Nimer, {Stephen D} and Carol Portlock and David Straus and Ariela Noy and Owen O'Connor and Filippa, {Daniel A.} and Julie Teruya-Feldstein and Alison Gencarelli and Jing Qin and Alyson Waxman and Joachim Yahalom and Craig Moskowitz",
year = "2004",
month = "5",
day = "15",
doi = "10.1182/blood-2003-11-3911",
language = "English",
volume = "103",
pages = "3684--3688",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "10",

}

TY - JOUR

T1 - Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma

AU - Kewalramani, Tarun

AU - Zelenetz, Andrew D.

AU - Nimer, Stephen D

AU - Portlock, Carol

AU - Straus, David

AU - Noy, Ariela

AU - O'Connor, Owen

AU - Filippa, Daniel A.

AU - Teruya-Feldstein, Julie

AU - Gencarelli, Alison

AU - Qin, Jing

AU - Waxman, Alyson

AU - Yahalom, Joachim

AU - Moskowitz, Craig

PY - 2004/5/15

Y1 - 2004/5/15

N2 - Patients with relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) who achieve complete response (CR) before autologous stem cell transplantation (ASCT) generally have better outcomes than those who achieve only partial response (PR). We investigated whether adding rituximab to the ifosfamide-carboplatin-etoposide (ICE) chemotherapy regimen (RICE) could increase the CR rate of patients with DLBCL under consideration for ASCT. Thirty-six eligible patients were treated with RICE, and 34 received all 3 planned cycles. The CR rate was 53%, significantly better than the 27% CR rate (P = .01) achieved among 147 similar consecutive historical control patients with DLBCL treated with ICE; the PR rate was 25%. Febrile neutropenia was the most frequent grade 3 or 4 nonhematologic toxicity; It occurred in 7.5% of delivered cycles. No patient had RICE-related toxicity that precluded ASCT. The median number of CD34+ cells per kilogram mobilized was 6.3 × 106. Progression-free survival rates of patients who underwent transplantation after RICE were marginally better than those of 95 consecutive historical control patients who underwent transplantation after ICE (54% vs 43% at 2 years; P = .25). RICE appears to induce very high CR rates in patients with relapsed and refractory DLBCL; however, further studies are necessary to determine whether this treatment regimen will improve outcomes after ASCT.

AB - Patients with relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) who achieve complete response (CR) before autologous stem cell transplantation (ASCT) generally have better outcomes than those who achieve only partial response (PR). We investigated whether adding rituximab to the ifosfamide-carboplatin-etoposide (ICE) chemotherapy regimen (RICE) could increase the CR rate of patients with DLBCL under consideration for ASCT. Thirty-six eligible patients were treated with RICE, and 34 received all 3 planned cycles. The CR rate was 53%, significantly better than the 27% CR rate (P = .01) achieved among 147 similar consecutive historical control patients with DLBCL treated with ICE; the PR rate was 25%. Febrile neutropenia was the most frequent grade 3 or 4 nonhematologic toxicity; It occurred in 7.5% of delivered cycles. No patient had RICE-related toxicity that precluded ASCT. The median number of CD34+ cells per kilogram mobilized was 6.3 × 106. Progression-free survival rates of patients who underwent transplantation after RICE were marginally better than those of 95 consecutive historical control patients who underwent transplantation after ICE (54% vs 43% at 2 years; P = .25). RICE appears to induce very high CR rates in patients with relapsed and refractory DLBCL; however, further studies are necessary to determine whether this treatment regimen will improve outcomes after ASCT.

UR - http://www.scopus.com/inward/record.url?scp=1842829171&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1842829171&partnerID=8YFLogxK

U2 - 10.1182/blood-2003-11-3911

DO - 10.1182/blood-2003-11-3911

M3 - Article

C2 - 14739217

AN - SCOPUS:1842829171

VL - 103

SP - 3684

EP - 3688

JO - Blood

JF - Blood

SN - 0006-4971

IS - 10

ER -