Cytoreduction and Stem Cell Mobilization With Rituximab and ICE for Patients With Refractory or Relapsed CD20+ B-Cell IGL Eligible for ASCT: The RICE Protocol
OBJECTIVES: I. Determine the complete response rate in patients with relapsed or refractory
CD20-positive diffuse large cell, immunoblastic, or anaplastic large cell lymphoma treated
with cytoreduction and mobilization with rituximab, ifosfamide, carboplatin, and etoposide
(RICE). II. Assess the ability of this regimen to deplete the stem cell harvest of B-cells
and tumor cells in these patients. III. Assess the efficacy of this regimen to mobilize
peripheral blood progenitor cells in these patients. IV. Assess the safety and toxicity of
this regimen in these patients.
OUTLINE: Cytoreduction and mobilization: Patients receive ifosfamide IV over 24 hours and
carboplatin IV on day 4 and etoposide IV over 1 hour on days 3-5. Chemotherapy repeats every
2 weeks for 3 courses. Patients receive rituximab IV on day -2 before initiation of
chemotherapy and on day 1 of each course of chemotherapy. Patients receive filgrastim
(G-CSF) subcutaneously (SC) daily on days 7-14 of each course of chemotherapy. Patients with
complete or partial response after completion of course 3 continue to receive G-CSF SC daily
until peripheral blood stem cells (PBSC) are harvested. When blood counts recover, PBSC are
harvested and selected for CD34+ cells. If sufficient numbers of CD34+ cells are not
obtained, patients undergo bone marrow harvest.
PROJECTED ACCRUAL: A total of 36 patients will be accrued for this study within 2 years.
Primary Purpose: Treatment
Craig Moskowitz, MD
Memorial Sloan-Kettering Cancer Center
United States: Federal Government
|Memorial Sloan-Kettering Cancer Center||New York, New York 10021|