title: ICE (chemotherapy)
text: # ICE (chemotherapy)
  
  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:
  
  * Rituximab - an anti-CD20 monoclonal antibody, which is able to kill both normal and malignant CD20-bearing B cells;
  * Ifosfamide - an alkylating antineoplastic agent of the oxazafosforine group;
  * Carboplatin - a platinum-based antineoplastic drug, also an alkylating antineoplastic agent;
  * Etoposide - a topoisomerase inhibitor.
  
  ## Dosing regimen
  
  | Drug | Dose | Mode | Days |
  | - | - | - | - |
  | Rituximab | 375 $mg/m^2$ | IV infusion | Day 1 |
  | Ifosfamide | 5000 $mg/m^2$ | IV continuous infusion over 24 hours | Day 2 |
  | Mesna for haemorrhagic cystitis prophylaxis with ifosfamide | 5000 $mg/m^2$ | IV continuous infusion over 24 hours | Day 2 |
  | Carboplatin | Optimized to get AUC = 5 (max. 800 mg) | IV infusion | Day 2 |
  | Etoposide | 100 $mg/m^2$ | 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).
  
  