ICE chemotherapy is a type of treatment for Hodgkin and non-Hodgkin lymphoma that has come back. ICE stands for the drugs ifosfamide, carboplatin, and etoposide.

A close up photo of an intravenous drip for ICE chemotherapy.Share on Pinterest
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Chemotherapy is a cancer treatment that uses cytotoxic drugs to kill cancerous cells.

Different chemotherapy drugs work in different ways. Doctors will recommend one chemotherapy drug or a combination depending on:

  • the type of cancer
  • the stage of the cancer
  • the person’s overall health

Doctors may recommend ICE chemotherapy for people with Hodgkin or non-Hodgkin lymphoma that has come back. Many people who have ICE chemotherapy also have a stem cell transplant.

According to the Centers for Disease Control and Prevention (CDC), lymphoma refers to cancer that starts in white blood cells in the lymph system. Tissues and organs in the lymph system produce, store, and carry white blood cells, which fight infections. Lymphoma develops in white blood cells called lymphocytes.

ICE stands for ifosfamide, carboplatin, and etoposide. These are three separate chemotherapy drugs that work by killing cancer cells. Doctors often recommend another drug alongside ICE, called rituximab, with a treatment they refer to as R-ICE therapy.

Learn more about chemotherapy.

Healthcare professionals administer ICE chemotherapy intravenously, via a drip, directly into the bloodstream.

The ICE treatment program can vary from place to place.

In most cases, people will have 2–4 cycles of treatment, with each cycle typically lasting around 3 weeks. A typical cycle may include:

  • day 1: one-hour drip of etoposide
  • day 2: one-hour drip of etoposide, a 1-hour drip of carboplatin, and a 24-hour drip of ifosfamide
  • day 3: one-hour drip of etoposide
  • days 4 to 21: no treatment

Chemotherapy drugs often cause side effects, which vary from person to person.

These drugs travel throughout the body, destroying fast-growing cancer cells. At the same time, they can also damage healthy cells, leading to side effects.

According to the American Cancer Society (ACS), chemotherapy commonly affects the following healthy cells:

  • blood-forming cells in the bone marrow
  • hair follicles
  • cells in the mouth
  • cells in the digestive tract and reproductive system

Some side effects will go away quickly, but others can take longer. Sometimes, chemotherapy can do long-term damage to the heart, lungs, kidneys, or reproductive organs. Doctors call these late effects.

The ACS says that people need to weigh unpleasant side effects against the need to kill cancer cells.

Common side effects

Common side effects occur in more than 10% of people who have ICE chemotherapy. They can include:

  • hair loss
  • breathlessness
  • feeling tired or weak
  • bruises
  • bleeding
  • feeling sick
  • being sick
  • loss of appetite
  • constipation
  • abdominal pain
  • kidney damage

Occasional side effects

Of people undergoing ICE chemotherapy, 1–10% may experience:

  • dizziness
  • diarrhea
  • itchy or red skin
  • a rash on the skin
  • numb or tingly fingers and toes
  • changes in taste
  • eye problems
  • sore mouth
  • lung problems

Rare side effects

Fewer than 1% of people may experience a rare side effect. These include:

Learn more about chemotherapy’s side effects.

Anyone who experiences the following side effects should contact their cancer care team right away:

  • bleeding or unexplained bruises
  • a rash
  • an allergic reaction, such as swelling in the mouth or throat, trouble swallowing, or severe itching
  • intense chills
  • pains or soreness in the drip area
  • intense headaches or other unusual pains
  • shortness of breath
  • persistent vomiting or diarrhea
  • blood in stool
  • blood in urine
  • a temperature of more than 101°F (38.3°C)

Anyone who has trouble breathing should call 911 before contacting their cancer care team.

Below are answers to some common questions about ICE chemotherapy.

Can I try to get pregnant during treatment?

ICE chemotherapy may harm a developing fetus. Therefore, doctors do not recommend becoming pregnant if a person or their partner is undergoing chemotherapy and for a few months afterward.

Can I have immunizations during treatment?

Immunizations, or vaccines, work by helping the body’s immune system recognize and fight infections and diseases. However, chemotherapy affects the immune system and how immunizations do their job.

The ACS recommends against most vaccines during chemotherapy treatment, particularly live vaccines. However, people should still get the flu shot. Most doctors agree that all cancer patients should also get the COVID-19 vaccine.

Anyone with concerns about having vaccinations during ICE chemotherapy can speak with their cancer care team.

What is the success rate of ICE chemotherapy?

Success rates of ICE vary according to several factors. They include whether a person is receiving other drugs and treatments in combination with ICE therapy. It also depends on their circumstances, including their age, type of tumor, and cancer stage.

People can consult their cancer care team about the ICE chemotherapy success rates that relate to them.

The outlook for people with Hodgkin and non-Hodgkin lymphoma varies.

The overall 5-year relative survival rate of all individuals with Hodgkin lymphoma in the United States is 88%. That means 88 of every 100 people with a diagnosis will still be alive 5 years later.

When doctors find cancer in its earliest stages, the 5-year survival rate is 92%. If doctors find cancer after it has spread to different parts of the body, the 5-year survival rate is 82%.

The overall 5-year survival rate for people with non-Hodgkin lymphoma in the United States is 73%.

ICE chemotherapy refers to a chemotherapy regimen that includes ifosfamide, carboplatin, and etoposide. Doctors often prescribe this treatment for people with Hodgkin lymphoma and non-Hodgkin lymphoma that has come back. Many individuals who undergo ICE chemotherapy also have a stem cell transplant.

Side effects, such as hair loss and feeling sick, are common. Others, such as allergic reactions and long-term organ damage, are rare.

ICE chemotherapy success rates and lymphoma survival rates vary greatly. Factors that affect treatment success include a person’s age, tumor type, and cancer stage. People can speak with their cancer care team about the risks and benefits of their treatment plan.