PURPOSE: To evaluate a chemotherapy regimen that consisted of ifosfamide administered as an infusion with bolus carboplatin, and etoposide (ICE) supported by granulocyte 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% v 30%; P =.003). The median number of CD34(+) cells/kg collected was 8.4 x 10(6). 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.
PURPOSE: To evaluate a chemotherapy regimen that consisted of ifosfamide administered as an infusion with bolus carboplatin, and etoposide (ICE) supported by granulocyte 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% v 30%; P =.003). The median number of CD34(+) cells/kg collected was 8.4 x 10(6). 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.
Authors: Michael Crump; Sattva S Neelapu; Umar Farooq; Eric Van Den Neste; John Kuruvilla; Jason Westin; Brian K Link; Annette Hay; James R Cerhan; Liting Zhu; Sami Boussetta; Lei Feng; Matthew J Maurer; Lynn Navale; Jeff Wiezorek; William Y Go; Christian Gisselbrecht Journal: Blood Date: 2017-08-03 Impact factor: 22.113
Authors: Ulas D Bayraktar; Juan Carlos Ramos; Adam Petrich; Neel Gupta; Shelly Lensing; P C Moore; Erin G Reid; David M Aboulafia; Lee Ratner; Ronald Mitsuyasu; Timothy Cooley; David H Henry; Paul Barr; Ariela Noy Journal: Leuk Lymphoma Date: 2012-07-09
Authors: M Mohty; K Hübel; N Kröger; M Aljurf; J Apperley; G W Basak; A Bazarbachi; K Douglas; I Gabriel; L Garderet; C Geraldes; O Jaksic; M W Kattan; Z Koristek; F Lanza; R M Lemoli; L Mendeleeva; G Mikala; N Mikhailova; A Nagler; H C Schouten; D Selleslag; S Suciu; A Sureda; N Worel; P Wuchter; C Chabannon; R F Duarte Journal: Bone Marrow Transplant Date: 2014-03-31 Impact factor: 5.483
Authors: P Schütt; K Zimmermann; C Derks; P Ebeling; A Welt; M Poser; J Hense; K Metz; J Anhuf; M Sandmann; M Neise; T Moritz; M Stuschke; N Niederle; S Seeber; Mohammad R Nowrousian Journal: J Cancer Res Clin Oncol Date: 2008-08-29 Impact factor: 4.553
Authors: Thomas E Witzig; Susan M Geyer; Paul J Kurtin; Joseph P Colgan; David J Inwards; Ivana N M Micallef; Betsy R LaPlant; John C Michalak; Muhammad Salim; Robert J Dalton; Dennis F Moore; Craig B Reeder Journal: Leuk Lymphoma Date: 2008-06
Authors: Santosha Vardhana; Paul A Hamlin; Joanna Yang; Andrew Zelenetz; Craig S Sauter; Matthew J Matasar; Andy Ni; Joachim Yahalom; Craig H Moskowitz Journal: Biol Blood Marrow Transplant Date: 2018-06-15 Impact factor: 5.742