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 H 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

doi:10.1200/JCO.1999.17.12.3776

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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 article

Peer reviewed

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 H Moskowitz, Joseph R Bertino, Jill R Glassman, Eric E Hedrick, Sonia Hunte, Nancy Coady-Lyons, David B Agus, Andre Goy, Joseph Jurcic, Ariela Noy, …

Journal of clinical oncology, Vol.17(12), pp.3776-3785

12/1999

DOI: https://doi.org/10.1200/JCO.1999.17.12.3776

PMID: 10577849

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% v 30%; 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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Title: Ifosfamide, Carboplatin, and Etoposide: A Highly Effective Cytoreduction and Peripheral-Blood Progenitor-Cell Mobilization Regimen for Transplant-Eligible Patients With Non-Hodgkin's Lymphoma
Creators: Craig H Moskowitz - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Joseph R Bertino - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Jill R Glassman - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Eric E Hedrick - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Sonia Hunte - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Nancy Coady-Lyons - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
David B Agus - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Andre Goy - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Joseph Jurcic - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Ariela Noy - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
James O'Brien - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Carol S Portlock - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
David S Straus - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Barrett Childs - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Richard Frank - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Joachim Yahalom - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Daniel Filippa - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Diane Louie - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Stephen D Nimer - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Andrew D Zelenetz - From the Lymphoma and Hematology Services, Department of Medicine, and Departments of Radiotherapy, Pathology, and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Publication Details: Journal of clinical oncology, Vol.17(12), pp.3776-3785
Date published: 12/1999
Academic Unit: Bertino Office
Language: English
Resource Type: Journal article
Identifiers: 991031665403004646