Need to know the diffrence

Need to know the diffrence between r-chop & RICE... Is one more painful or is there a diffrence for treating re-occuring non hodkins lymphoma that is large b-cell & reoccured

Allison - Information about

Allison -
Information about the R-CHOP regimen can be found HERE. As you may know, CHOP, and now R-CHOP, is considered conventional chemotherapy treatment for large b cell lymphoma.

The "R-ICE" regimen consists of:


Rituximab is the monoclonal antibody that is generally given to you first; there's information on rituximab (aka Rituxan, MabThera) on the above blog entry and elsewhere on this site.

Ifosfamide is an alkylating agent (i.e. how it kills cells) that has the potential to harm your bladder, so you're supposed to drink lots of liquids. Plus the drug mesna, which protects the bladder, is normally given along with the Ifosfamide.

Like Ifosfamide, carboplatin is an alkylating agent. It can reduce your white blood cell count even in the weeks after being administered, leaving the patient more prone to infections. Same is true with platelets, putting you at higher risk of bleeding problems.

Etoposide is derived from a plant and kills cells by inhibiting an enzyme from keeping DNA healthy. It has the same side-effects as the other two drugs, but etoposide presents an added, although rare, risk of developing a cancer like leukemia years down the road. The American Cancer Society says, "If you are getting this drug, your doctor feels this risk is outweighed by the risk of what might happen if you do not get this drug. You may want to discuss these risks with your doctor."

So the differences: R-CHOP features a steroid, prednisolone, and in my own opinion (based not on personal experience but on an understanding of the medications and the patient reports), the drugs used in R-CHOP—specifically the doxorubicin (hydoxydaunorubicin, the H) and the vincristine (Oncovin, the O), are particularly rough chemo drugs with really nasty potential side effects (keyword, potential—you won't necessarily experience them).

Right now, standard chemotherapy treatment for DLBCL is the R-CHOP regimen. If it fails, then doctors turn to R-ICE (or ESHAP, or DHAP, with or without rituximab added). I think this is why I had trouble finding clinical data comparing R-ICE to R-CHOP--because R-CHOP is considered the standard. I did find this very recent study, which compared R-ICE against R-DHAP and found no significant difference.

Bottom line, on paper R-ICE would seem to present fewer major side effects than R-CHOP but it may not be as effective a treatment.

The good news is that DLBCL is highly treatable and even curable with chemo.
Talk to your doctors about these drugs, and best of luck to you!


Hunt, Kristin E; Reichard, . "Diffuse Large B-Cell Lymphoma." Archives of Pathology & Laboratory Medicine. College of American Pathologists. 2008.

"Seattle Genetics Initiates SGN-40 Phase IIb Clinical Trial in Combination with Rituxan and Chemotherapy for Diffuse Large B-Cell Non-Hodgkin's Lymphoma." Business Wire. Business Wire. 2007.

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