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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3684-3688. Prepublished online as a Blood First Edition Paper on January 22, 2004; DOI 10.1182/blood-2003-11-3911. This Article Full Text (PDF) All Versions of this Article: 2003-11-3911v1 103/10/3684    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kewalramani, T. Articles by Moskowitz, C. H Search for Related Content PubMed PubMed Citation Articles by Kewalramani, T. Articles by Moskowitz, C. H Social Bookmarking                   What's this? Submitted November 14, 2003 Accepted January 14, 2004 Rituximab and ICE (RICE) as second-line therapy prior to autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma Tarun Kewalramani*, Andrew D Zelenetz, Stephen D Nimer, Carol Portlock, David Straus, Ariela Noy, Owen O'Connor, Daniel A Filippa, Julie Teruya-Feldstein, Alison Gencarelli, Jing Qin, Alyson Waxman, Joachim Yahalom, and Craig H Moskowitz Memorial Sloan-Kettering Cancer Center, New York, NY, USA * Corresponding author; email: kewalrat{at}mskcc.org. Patients with relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) who achieve a complete response (CR) before autologous stem cell transplantation (ASCT) generally have a better outcome than those who achieve only a partial response (PR). We investigated whether adding rituximab to the ICE chemotherapy regimen (RICE) could increase the CR rate in patients with DLBCL being considered for ASCT. Thirty-six eligible patients were treated with RICE and 34 received all three planned cycles. The CR rate was 53%, significantly better than the 27% CR rate (P=0.01) achieved among 147 similar consecutive historical control patients with DLBCL treated with ICE alone; the PR rate was 25%. Febrile neutropenia was the most frequent grade 3-4 non-hematologic toxicity, occurring in 7.5% of delivered cycles. No patient had RICE-related toxicity that precluded ASCT. The median number of CD34+ cells/kg mobilized was 6.3 x 106. The progression-free survival of patients transplanted after RICE was marginally better than that of 95 consecutive historical control patients transplanted after ICE (54% vs. 43% at 2 years, P=0.25). RICE appears to induce a very high CR rate in patients with relapsed or refractory DLBCL; however, further studies are necessary to determine whether this treatment regimen will improve outcomes after ASCT. 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