Ice chemotherapy is typically administered at infusion centers, where trained professionals can watch for adverse reactions. This regimen is then called ice r or r ice or rice. The purpose of this retrospective analysis was to evaluate the results of the rice rituximab, ifosfamide, carboplatin, etoposide protocol alone as compared to rice followed by highdose. As we strive to keep these documents uptodate, revisions are frequent and ongoing, we ask that you always obtain a new.
Ferme c, mounier n, divine m, brice p, stamatoullas a, reman o, voillat l, jaubert j, lederlin p, colin p, berger f, salles g. Rdhap combines rituximab with cisplatin, cytarabine, and dexamethasone. Additional regimens may be added over time, particularly as treatment for lymphoma. Acute lymphoblastic leukemia all treatment protocols. R chop, r ice, rituximab plus highdose cytarabine, and rituximab, gemcitabine, dexamethasone, and cisplatin. Chemotherapy is the treatment of cancer with drugs that can destroy cancer cells by impeding their growth and reproduction. When rituximab is given alongside a chemotherapy regimen, an r is added to the name. Ifosfamide is an anticancer antineoplastic or cytotoxic chemotherapy drug. Acronyms for chemotherapy regimens sometimes used to treat lymphoma. Chemotherapy is often given as a combination of drugs. Ice nonhodgkin lymphoma chemotherapy regimen doctors. Rice is a chemotherapy treatment that is used to treat lymphoma. Furthermore, the quality of the clinical response to ice predicts for.
The following material represents a subset of chemotherapy and immunotherapy regimens that are used for the treatment of patients with lymphoma. As we strive to keep these documents uptodate, revisions are frequent and ongoing, we ask that you always obtain a new form from this listing each time you prescribe these drugs. Nccn continues to add to the library of chemotherapy order templates to improve the safe use of drugs and biologics in cancer care. Provincial health services authority phsa improves the health of british columbians by seeking provincewide solutions to specialized health care needs in collaboration with bc health authorities and other partners. Rice chemotherapy with or without autologous transplantation for. This medication is classified as an alkylating agent. Nccp chemotherapy regimen rice rituximab, ifosfamide.
Randomised phase iii study of rice versus rdhap in relapsed patients with cd20 diffuse large bcell lymphoma dlbcl followed by highdose therapy and a second randomisation to maintenance treatment with rituximab or not. Provincial health services authority phsa improves the health of british columbians by seeking provincewide solutions to specialized health care needs in. The majority of drugs used in cancer chemotherapy are cytostatic, many via cytotoxicity a fundamental philosophy of medical. The majority of drugs used in cancer chemotherapy are cytostatic, many via. Cisplatin is administered in 500ml sodium chloride 0. The list of disease and specialty groups below are links to available chemotherapy orders and consents frequently used in their treatment. Radiotherapy begins 3 weeks after last cycle of rchop. Chemotherapyrefractory diffuse large bcell lymphoma and. Patient may be off continuous iv chemotherapy no longer than 30 minutes24 hours carboplatin dose adjustment parameters physician to complete do not adjust as long as creatinine clearance remains above select one. The originally described ice regimen requires the delivery of. Ice chemotherapy, with ifosfamide administered as a 24hour 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. Rice chemotherapy regimen for lymphoma patient education. R ice indication salvage treatment for relapsed or refractory lymphoma.
To evaluate a chemotherapy regimen that consisted of ifosfamide administered as an infusion with bolus carboplatin, and etoposide ice supported by granuloctye colonystimulating factor gcsf for cytoreduction and stemcell mobilization in transplanteligible patients with primary refractory or relapsed nonhodgkins lymphoma nhl. Instructions on how you can make a pdf version of this page using the print function. None of the regimens showed a difference in efficacy based on chemotherapy administration sequencing. Outpatientbased ifosfamide, carboplatin and etoposide ice chemotherapy in transplanteligible patients with nonhodgkins lymphoma and hodgkins disease. Ifosfamide is give through an infusion into a vein intravenous, iv.
Rituximab, ifosfamide, carboplatin, etoposide, mesna. Systemic chemotherapy with prophylactic cns directed therapy has been advocated for some patients, but evidence in favour of such treatment suffers from the lack of randomized clinical trials and. Rice rituximab, ifosfamide, carboplatin and etoposide therapy. Salvage therapy for patients with refractoryrelapsed bcell nonhodgkin lymphoma nhl is based on polychemotherapy, followed by highdose therapy and autologous stem cell transplantation in eligible patients hdtasct. Icerice ifosfamide, carboplatin, and etoposide without or with rituximab chemotherapy followed by autologous stem cell transplantation is an established regimen in refractoryrelapsed lymphoma. Anyways, i will be starting rice chemotherapy march 6th and will do either 2 or 3 rounds of it until i have a date for when i start autologous stem cell transplant. Chemo orders and consents penn state cancer institute. The value of highdose systemic chemotherapy and intrathecal therapy for central nervous system prophylaxis in different risk groups of adult acute lymphoblastic leukemia. Omit rituximab if cd20negative and consider omitting rituximab if relapsed rapidly. In table 1 type and duration of the most common therapeutic protocol for treating acute and chronic myeloid and lymphoid neoplasm of adults are reported.
The information contained in the nccn templates is based on the nccn clinical practice guidelines in oncology. The ifosfamidecarboplatinetoposide ice regimen is an effective, doseintense, shortcourse cytoreductive regimen capable of mobilizing peripheral blood progenitor cells pbpcs with minimal extramedullary toxicity. Hertzberg ms1, crombie c, benson w, taper j, gottlieb d, bradstock kf. At cancer treatment centers of america ctca, we work closely with our patients to meet your individual needs before, during and after chemotherapy treatment. Each of the drugs in this combination is approved by the food and drug administration fda to treat cancer or conditions related to cancer. Rchop, rice, rituximab plus highdose cytarabine, and rituximab, gemcitabine. Antiemetic therapy should be administered throughout the duration of the chemotherapy protocol and to cover delayed nausea. Rituximab, dexamethasone, cytarabine, and oxaliplatin r.
Omit rituximab if cd20negative and consider omitting rituximab if relapsed rapidly following rituximabcontaining regimen. This is an intense chemotherapy regimen and patients with poor ecog performance status and significant comorbidities may not be appropriate for this. The resistance of this lymphoma to chemotherapy was demonstrated by the fact that it progressed 1 month after the patient received each of four different chemoimmunotherapy regimens. Highdose chemoradiotherapy for relapsed or refractory. In a multidrug regimen, each medication has unique side effects. An ice chemotherapy regimen is designed to limit the chances of adverse side effects while providing the. The purpose of this retrospective analysis was to evaluate the results of the r ice rituximab, ifosfamide, carboplatin, etoposide protocol alone. Ice in the context of chemotherapy is an acronym for one of the chemotherapy regimens, used in salvage treatment of relapsed or refractory nonhodgkins lymphoma and hodgkin lymphoma. Longterm followup results of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and. The acute and delayed emetic risk of multiday chemotherapy protocols will overlap depending on the individual drugs and their sequence of administration. An ice chemotherapy regimen is designed to limit the chances of adverse side effects while providing the maximum positive response possible.
Bc cancer systemic therapy program has placed summaries of specific treatment protocols on the website. Hodgkins lymphoma patients will not receive rituximab as below. After reading everyones experiences, it looks like r ice is very similar to eepoch. Prof elizabeth vandenberghe, prof maccon keane page 2 of 7. Outpatientbased ifosfamide, carboplatin and etoposide ice. Nonhodgkin lymphoma rice rituximab infusional ifosfamide. Rice indication salvage treatment for relapsed or refractory lymphoma. Continue hydration throughout chemotherapy and for 12 hours after completion of ifosfamide. Randomised phase iii study of r ice versus r dhap in relapsed patients with cd20 diffuse large bcell lymphoma dlbcl followed by highdose therapy and a second randomisation to maintenance treatment with rituximab or not. Treatment of certain types of nonhodgkins lymphoma. Treatment usually depends both on the type of lymphoma and the stage extent of the disease, but many other factors can be important as well.
Outpatientbased ifosfamide, carboplatin and etoposide. Hodgkins lymphoma patients will not receive rituximab as. Questions about rice chemotherapy cancer survivors network. Choplike chemotherapy plus rituximab versus choplike chemotherapy alone in young patients with goodprognosis diffuse largebcell lymphoma. Record stage of disease petct ct scan with contrast chest, abdomen and pelvis, presence or absence of bsymptoms, clinical extent of disease, consider bone marrow trephine. Ice in the context of chemotherapy is an acronym for one of the chemotherapy regimens, used in salvage treatment of relapsed or refractory nonhodgkins lymphoma and hodgkin lymphoma in case of cd20positive b cell lymphoid malignancies the ice regimen is often combined today with rituximab. These summaries are those in current use by the systemic therapy program staff at all regional cancer centres. After reading everyones experiences, it looks like rice is very similar to eepoch. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.
Rice is most often associated with treatment of nonhodgkins lymphoma. Lymphoma action chemotherapy regimens for lymphoma. Because there are lots of drugs and fluids given with rice chemotherapy, you may. The following material represents a subset of chemotherapy regimens that are used for the treatment of patients with lymphoma. From wikibooks, open books for an open world protocol. Vesicants are administered first with no difference given for peripheral versus central line administration. Ice r ice ifosfamide, carboplatin, and etoposide without or with rituximab chemotherapy followed by autologous stem cell transplantation is an established regimen in refractoryrelapsed lymphoma. May 15, 2004 the ifosfamidecarboplatinetoposide ice regimen is an effective, doseintense, shortcourse cytoreductive regimen capable of mobilizing peripheral blood progenitor cells pbpcs with minimal extramedullary toxicity. Department of medical oncology chemotherapy protocols 3rd edition 90 protocol.
Examples include rchop, rice, rcvp and rbendamustine. Radiation oncologychemotherapy combinations wikibooks. Salvage treatment for relapsed or refractory lymphoma. Chemotherapy nursing is a level 6 module that aims to develop the students knowledge of chemotherapy mainly systemic anticancer therapy or sact, promote competent and safe practice and develop an understanding of the physical, psychosocial and spiritual sideeffects that are. Intensive salvage therapy with highdose chemotherapy for patients with advanced hodgkins disease in relapse or failure after initial chemotherapy. We want to help everyone with cancer live life as fully as they can. This page is for listing chemotherapy combinations, e. Drug dose ivinfusionoral q cyclophosphamide 750mgm2 iv day 1 vincristine 1. Efficacy of rice as second line chemotherapy in transplant. Ensure histology is confirmed prior to administration of chemotherapy and document in notes. Interactions between antiretrovirals and antineoplastic drug therapy. Rituximab is usually used only for bcell nonhodgkin lymphomas.
A chemotherapy regimen is a regimen for chemotherapy, defining the drugs to be used, their dosage, the frequency and duration of treatments, and other considerations. Based on this information, our own institutional guidelines for drug sequencing are as follows. Rituximab and ice as secondline therapy before autologous. In case of cd20 positive b cell lymphoid malignancies the ice regimen is often combined today with rituximab. Pdf outpatientbased ifosfamide, carboplatin and etoposide. Prof elizabeth vandenberghe, prof maccon keane page 1 of 7 the information contained in this document is a statement of consensus of nccp and ismo or ihs. Jul 02, 2018 repeat each cycle every 3 weeks for 3 cycles. Pdf outpatientbased ifosfamide, carboplatin and etoposide ice.
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