rituximab + ifosfamide + carboplatin + etoposide + cyclophosphamide

This combination chemoimmunotherapy regimen, often referred to as R-ICE followed by high-dose cyclophosphamide (HiCy), is an intensive treatment strategy evaluated by the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. It is specifically designed for patients with aggressive B-cell lymphomas, such as diffuse large B-cell lymphoma (DLBCL) and mediastinal (thymic) B-cell lymphoma, who remain PET-positive after initial R-CHOP induction. The regimen incorporates rituximab, a monoclonal antibody targeting CD20, with ifosfamide, carboplatin, and etoposide (R-ICE), and is further intensified with high-dose cyclophosphamide. The mechanism of action involves a multi-pronged attack: rituximab mediates cell lysis through immune-effector mechanisms, while the cytotoxic agents act as DNA alkylators or topoisomerase II inhibitors to disrupt DNA replication and induce cell death in rapidly dividing cancer cells.

Other names

R-ICE + high-dose cyclophosphamideR-ICE + HiCyR-ICE plus high-dose cyclophosphamide