A.

Name/ Abbreviation of Regimen

RICE (Rituximab, ifosfamide, carboplatin, and etoposide)
B. Indication (cancer type, stage, goal of therapy)
diffuse large B-cell lymphoma: relapsed or refractory
achieve maximum tumor burden cytoreduction in preparation for HDC with ASCT
C. Common dosing and frequency
Rituximab: 375 mg/m2 IV D1 over 90 min
D1,2,3: Ifosfamide: 1667 mg/m2/day IV over 3h, Mesna: 334.4 mg/m2/day IV 3h,
IV Carboplatin (AUC=5) over 1h, IV Etoposide 100 mg/m 2/day over 30 to 60 min,
PO Mesna 666.8 mg/m2/day at 2h and 6h post ifosfamide
Every 14d for 3 cycles
D. Duration of administration of each drug

E. Diluent required (type, vol, stability)

Rituximab: NS 500ml, Ifosfamide: NS 500ml, Carboplatin: NS 250, Etoposide: NS
500, Mesna: NS 500
F. Premeds required? Reason for premed?
IV Diphenhydramine 25mg (D1), PO Paracetamol 1g (D2), IV Furosemide 20mg
(D1, D2,D3)
G. Antiemetic required? (acute/delayed/breakthrough)
Emesis risk: MODERATE (30 to 90 percent frequency of emesis).
Acute (IV Dexa 8mg, IV Grani 3mg)
Delayed (PO Dexa 4mg BD x 3D, PO Maxolon, PO Grani 1mg x 3D)
H. Hydration required? (Volume/Duration/Electrolytes/Diuretics)
Nil
I. Growth factor support required?
Yes
J. Antibiotic/Antiviral prophylaxis required?

K. Monitoring parameters (baseline and prior to each dose)

Dipstick urine for hematuria daily
FBC, U/E (Carboplatin, ifosfamide, etoposide), LFT (Ifosfamide, Etoposide)
L. Possible side effects
Ifos: Hemorrhagic cystitis (hematuria), CNS toxicity or encephalopathy,
nausea/vomiting, metabolic acidosis. May cause severe nephrotoxicity, resulting
in renal failure.
Myelosuppression
Etoposide: hypotension

M. Counselling points

N. Patient specific precautions (prior hypersensitivity, side effects

experienced, protocol deviation, intervention done thus far)

O. Any other relevant information