ICE in the context of chemotherapy is an acronym for one of the chemotherapy regimens, used in salvage treatment of relapsed or refractory non-Hodgkin's lymphoma and Hodgkin lymphoma.
In case of CD20-positive B cell lymphoid malignancies the ICE regimen is often combined today with rituximab. This regimen is then called ICE-R or R-ICE or RICE.
[R]-ICE regimen consists of:[ citation needed ]
Drug | Dose | Mode | Days |
---|---|---|---|
Rituximab | 375 mg/m2 | IV infusion | Day 1 |
Ifosfamide | 5000 mg/m2 | IV continuous infusion over 24 hours | Day 2 |
Mesna for haemorrhagic cystitis prophylaxis with ifosfamide | 5000 mg/m2 | IV continuous infusion over 24 hours | Day 2 |
Carboplatin | Optimized to get AUC = 5 (max. 800 mg) | IV infusion | Day 2 |
Etoposide | 100 mg/m2 | IV infusion over 1 hour | Days 1-3 |
Filgrastim to shorten the period of neutropenia | 5 μg/kg | S.C. | Days 5-12 |
Cycles are repeated every 14 days for 3 cycles, then high-dose chemotherapy with autologous stem-cell transplantation follows (if the patient is considered eligible for HDCT and ASCT). [1] [2]
Anaplastic large-cell lymphoma (ALCL) refers to a group of non-Hodgkin lymphomas in which aberrant T cells proliferate uncontrollably. Considered as a single entity, ALCL is the most common type of peripheral lymphoma and represents ~10% of all peripheral lymphomas in children. The incidence of ALCL is estimated to be 0.25 cases per 100,000 people in the United States of America. There are four distinct types of anaplastic large-cell lymphomas that on microscopic examination share certain key histopathological features and tumor marker proteins. However, the four types have very different clinical presentations, gene abnormalities, prognoses, and/or treatments.
Ibritumomab tiuxetan, sold under the trade name Zevalin, is a monoclonal antibody radioimmunotherapy treatment for non-Hodgkin's lymphoma. The drug uses the monoclonal mouse IgG1 antibody ibritumomab in conjunction with the chelator tiuxetan, to which a radioactive isotope is added. Tiuxetan is a modified version of DTPA whose carbon backbone contains an isothiocyanatobenzyl and a methyl group.
CHOP is the acronym for a chemotherapy regimen used in the treatment of non-Hodgkin lymphoma. CHOP consists of:
T-cell lymphoma is a rare form of cancerous lymphoma affecting T-cells. Lymphoma arises mainly from the uncontrolled proliferation of T-cells and can become cancerous.
Diffuse large B-cell lymphoma (DLBCL) is a cancer of B cells, a type of lymphocyte that is responsible for producing antibodies. It is the most common form of non-Hodgkin lymphoma among adults, with an annual incidence of 7–8 cases per 100,000 people per year in the US and UK. This cancer occurs primarily in older individuals, with a median age of diagnosis at ~70 years, although it can occur in young adults and, in rare cases, children. DLBCL can arise in virtually any part of the body and, depending on various factors, is often a very aggressive malignancy. The first sign of this illness is typically the observation of a rapidly growing mass or tissue infiltration that is sometimes associated with systemic B symptoms, e.g. fever, weight loss, and night sweats.
Richter's transformation (RT), also known as Richter's syndrome, is the conversion of chronic lymphocytic leukemia (CLL) or its variant, small lymphocytic lymphoma (SLL), into a new and more aggressively malignant disease. CLL is the circulation of malignant B lymphocytes with or without the infiltration of these cells into lymphatic or other tissues while SLL is the infiltration of these malignant B lymphocytes into lymphatic and/or other tissues with little or no circulation of these cells in the blood. CLL along with its SLL variant are grouped together in the term CLL/SLL.
Pixantrone is an experimental antineoplastic (anti-cancer) drug, an analogue of mitoxantrone with fewer toxic effects on cardiac tissue. It acts as a topoisomerase II poison and intercalating agent. The code name BBR 2778 refers to pixantrone dimaleate, the actual substance commonly used in clinical trials.
Mantle cell lymphoma (MCL) is a type of non-Hodgkin's lymphoma, comprising about 6% of cases. It is named for the mantle zone of the lymph nodes where it develops. The term 'mantle cell lymphoma' was first adopted by Raffeld and Jaffe in 1991.
Bendamustine, sold under the brand name Treanda among others, is a chemotherapy medication used in the treatment of chronic lymphocytic leukemia (CLL), multiple myeloma, and non-Hodgkin's lymphoma. It is given by injection into a vein.
Subcutaneous T-cell lymphoma is a cutaneous condition that most commonly presents in young adults, and is characterized by subcutaneous nodules. Common symptoms include fever, fatigue, and pancytopenia.
Gene expression profiling has revealed that diffuse large B-cell lymphoma (DLBCL) is composed of at least 3 different sub-groups, each having distinct oncogenic mechanisms that respond to therapies in different ways. Germinal Center B-Cell like (GCB) DLBCLs appear to arise from normal germinal center B cells, while Activated B-cell like (ABC) DLBCLs are thought to arise from postgerminal center B cells that are arrested during plasmacytic differentiation. The differences in gene expression between GCB DLBCL and ABC DLBCL are as vast as the differences between distinct types of leukemia, but these conditions have historically been grouped together and treated as the same disease.
Sequential high-dose chemotherapy is a chemotherapy regimen consisting of several sequential monochemotherapies with only one chemotherapeutic agent per course. The idea behind this approach is that when using single-agent chemotherapy, the doctor can easily escalate the dose of the drug to the maximum tolerable dose by the patient, avoiding additive hematological toxicity from chemotherapeutic combinations, and thus improving efficacy. It is mostly used as consolidation therapy for relapsed or refractory lymphomas and relapsed or refractory Hodgkin disease, after DHAP induction. There is also an ongoing trial of this approach in multiple myeloma.
DHAP in context of chemotherapy is an acronym for chemotherapy regimen that is used for remission induction in cases of relapsed or refractory non-Hodgkin lymphoma and Hodgkin's lymphoma. It is usually given for 2-3 courses, then followed by high-dose chemotherapy and autologous stem cell transplantation. In combination with anti-CD20 monoclonal antibody rituximab it is called R-DHAP or DHAP-R.
ESHAP is an acronym for relatively intensive chemotherapy regimen that is used for salvage therapy in relapsed or refractory lymphomas and Hodgkin's lymphoma. In combination with monoclonal antibody Rituximab it is called R-ESHAP or ESHAP-R.
EPOCH is an intensive chemotherapy regimen intended for treatment of aggressive non-Hodgkin's lymphoma.
CEPP is a chemotherapy regimen that is intended for treatment of aggressive non-Hodgkin lymphomas. It consists of cyclophosphamide, etoposide, procarbazine, and prednisone. Unlike CHOP, this chemotherapy regimen does not contain doxorubicin or any other anthracycline. Thus, it can be used in patients with severe cardiovascular diseases and contraindications for doxorubicin-containing regimens. This regimen also does not contain vincristine and can be used in patients with neuropathy.
MINE in the context of chemotherapy is an acronym for one of the chemotherapy regimens used for treatment of relapsed or refractory aggressive non-Hodgkin's lymphoma and Hodgkin's lymphoma.
GemOx or GEMOX is an acronym for one of the chemotherapy regimens used in the treatment of relapsed or primary refractory non-Hodgkin's lymphoma and Hodgkin's lymphoma.
FCM, or FMC in the context of chemotherapy is an acronym for a chemotherapy regimen that is used in the treatment of indolent B cell non-Hodgkin's lymphomas. In combination with Rituximab, this regimen is called R-FCM or R-FMC, or FCM-R, FMC-R.
Epstein–Barr virus–associated lymphoproliferative diseases are a group of disorders in which one or more types of lymphoid cells, i.e. B cells, T cells, NK cells, and histiocytic-dendritic cells, are infected with the Epstein–Barr virus (EBV). This causes the infected cells to divide excessively, and is associated with the development of various non-cancerous, pre-cancerous, and cancerous lymphoproliferative disorders (LPDs). These LPDs include the well-known disorder occurring during the initial infection with the EBV, infectious mononucleosis, and the large number of subsequent disorders that may occur thereafter. The virus is usually involved in the development and/or progression of these LPDs although in some cases it may be an "innocent" bystander, i.e. present in, but not contributing to, the disease.