Dexamethasone/ifosfamide/cisplatin/etoposide (DICE) as therapy for patients with advanced refractory non-Hodgkin's lymphoma: Preliminary report of a phase II study

• Published in: Annals of oncology 1991-01, Vol.2 (suppl-1), p.43-46
• Main Authors: Goss, Paul E., Shepherd, Frances A., Scott, J. Gerald, Warner, Ellen, Baker, Michael A., Sutton, David, Farquharson, Helen A., Buick, Susan, Sutcliffe, Simon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone Marrow - drug effects; Cisplatin - administration & dosage; Cisplatin - adverse effects; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; DICE; Drug Administration Schedule; Drug Evaluation; Etoposide - administration & dosage; Etoposide - adverse effects; Female; Humans; Ifosfamide - administration & dosage; Ifosfamide - adverse effects; Lymphoma, Non-Hodgkin - drug therapy; Lymphoma, Non-Hodgkin - mortality; Male; Middle Aged; refractory non-Hodgkin's lymphoma; Remission Induction; Survival Rate
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/2.suppl_1.43

Twenty-two patients with refractory intermediate- or high-grade non-Hodgkin's lymphoma were treated with dexamethasone 10 mg every six hours and ifosfamide 1 g/m2, cisplatin 25 mg/m2, etoposide 100 mg/ m2 (DICE), and mesna uroprotection daily ×4 every 3 to 4 weeks. Pretreatment with prochlorperazine and metoclopramide was given to prevent nausea and vomiting. Eighteen men and four women, aged 21 to 74 years (median age, 65) have received a total of 64 cycles. Seventeen patients had stage IV, one had stage III, and four patients had stage II disease. Seven patients had B symptoms and 11 had marrow involvement. Only two patients had had more than one previous chemotherapy regimen. Median time from last chemotherapy to DICE was 7 months (range, 1 to 41). Two patients who suffered early treatment-related deaths (from sepsis) were classified as nonresponders. Six of 22 patients (27%) achieved complete remission (2 to 22+ months), and 11 (50%) had partial remissions (1 to 8+ months) for an overall response rate of 77%. Median survival has not been reached yet, and 12 patients are alive 1 to 22 months from the start of treatment. Nine patients had nadir granulocyte counts less than 0.5×109/L; six required RBC transfusions and five, platelet transfusions. The platelet nadir was less than 50×109/L in 13 patients. Four patients had microscopic hematuria, two had grade 3 gastrointestinal toxicity, and one had a transient episode of delirium and blurred vision.