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Laboratory studies of the infrared spectral properties of CO in astrophysical ices.

Analysis of laboratory spectra of numerous astrophysical ice analogs demonstrates that the exact band position, width, and profile of the solid state CO fundamental near 2137 cm-1 (4.679 microns) can provide important information on the physical conditions present during the ice accretion phase as well as during any subsequent thermal processes and radiation exposure. In the ices studied, the CO peak position varies from 2134 to 2144 cm-1 (4.686 to 4.664 microns) and the band width from 2.1 to over 20 cm-1 depending on the composition of the ice. In an ice matrix dominated by H2O, the CO peak falls at 2136.7 cm-1, has a full width at half-maximum of about 9 cm-1, and shows a prominent sideband at 2152 cm-1. This sideband and minor structure superposed on the main band arise from CO trapped in different matrix sites. These features provide information concerning the thermal and radiation history of the ice. The solid CO band in interstellar spectra often has contributions from broad (12 cm-1) and narrow (5 cm-1) components. We identify the broad component with CO intimately mixed in matrices dominated by polar molecules, of which H2O is likely to be the major component. Examination of the interstellar and laboratory band profiles shows that either the abundance of nonpoplar impurities in these ices must be less than 10% or the ices have been thermally annealed or processed by ultraviolet radiation. The narrow component is likely to originate from grain mantles dominated by nonpolar molecules such as CO2. These components reflect differences in the physical and chemical conditions in regions of the cloud along the line of sight. Laboratory determination of the absorption strength of the CO fundamental in H2O-rich ices showed that the value used in the past was approximately 60% too low and that most previously determined solid-state CO column densities have been systematically overestimated. The rich spectral behavior of the CO band observed in the laboratory studies clearly indicates that future high-quality astronomical spectra in the 2200-2100 cm-1 range can produce a wealth of new information and provide deeper insights into the nature of astrophysical ices.

Astronomical Phenomena↗

Nosocomial legionellosis traced to a contaminated ice machine.

OBJECTIVE: To investigate a case of nosocomial legionellosis, identify pathways of transmission, and effect control of the environmental source. DESIGN: Case investigation and environmental culture surveillance. SETTING: A 720-bed university teaching hospital. CASE PATIENT: A ventilator-dependent 66-year-old male developed nosocomial pneumonia due to Legionella pneumophila serogroup 6 after 3 months in an intensive-care unit (ICU). The patient had no intake of potable water except for ice chips from an ice machine in the ICU. RESULTS: Cultures revealed L pneumophila serogroup 6 in the ice (4.3 colony-forming units/mL) and ice machine cold water (too numerous to count). Cultures from adjacent hot and cold taps, plus taps located near the patient, all were negative; ice machines and cold water on seven other patient units also were negative. Only sterile water had been used for tube feedings, mouth care, suctioning, and ventilator humidification. Hospital hot water previously had been colonized with L pneumophila serogroup 6, but all surveillance water cultures had been negative since chlorination of the hot-water system began the previous year; cold-water cultures had never before grown Legionella. The ice machine was disinfected with a 2-hour flush of 2.625% sodium hypochlorite. The supply line to the ice machine was replaced, and the cold-water pipe from the floor below was treated with 83 ppm sodium hypochlorite for 48 hours. All follow-up surveillance cultures of the ice machine remained negative through mid-1996. No additional cases of nosocomial legionellosis occurred. CONCLUSIONS: Ice machines may be reservoirs of L pneumophila in hospitals. Both ice and water dispensed from these machines may be contaminated, and nosocomial transmission may occur. Successful long-term decontamination and control can be accomplished with shock chlorination.

Aged↗

Theoretical study of interaction of winter flounder antifreeze protein with ice.

Antifreeze proteins (AFPs) are synthesized by various organisms to enable their cells to survive subzero environment. These proteins bind to small ice crystals and inhibit their growth, which if left uncontrolled would be fatal to cells. The crystal structures of a number of AFPs have been determined; however, crystallographic analysis of AFP-ice complex is nearly impossible. Molecular modeling studies of AFPs' interaction with ice surface is therefore invaluable. Early models of AFP-ice interaction suggested H-bond as the primary driving force behind such interaction. Recent experimental evidence, however, suggested that hydrophobic interactions could be the main contributor to AFP-ice association. All computational studies published to date were carried out to verify the H-bond model, and no works attempting to verify the hydrophobic interaction model have been published. In this work, we Monte Carlo-minimized complexes of several AFPs with ice taking into account nonbonded interactions, H-bonds, and the hydration potential for proteins. Parameters of the hydration potential for ice were developed with the assumption that the free energy of the water-ice association should be close to zero at equilibrium melting temperature. Our calculations demonstrate that desolvation of hydrophobic groups in the AFPs upon their binding to the grooves at the ice surface is indeed the major stabilizing contributor to the free energy of AFP-ice binding. This study is consistent with available structural and mutation data on AFPs. In particular, it explains the paradoxical finding that substitution of Thr residues with Val does not affect the potency of winter flounder AFP whereas substitution with Ser abolished its antifreeze activity.

Amino Acid Sequence↗

Modelled and measured dynamics of viruses in Arctic winter sea-ice brines.

We describe a model based on diffusion theory and the temperature-dependent mechanism of brine concentration in sea ice to argue that, if viruses partition with bacteria into sea-ice brine inclusions, contact rates between the two can be higher in winter sea ice than in seawater, increasing the probability of infection and possible virus production. To examine this hypothesis, we determined viral and bacterial concentrations in select winter sea-ice horizons using epifluorescence microscopy. Viral concentrations ranged from 1.6 to 82 x 10(6) ml(-1) of brine volume of the ice, with highest values in brines from coldest (-24 to -31 degrees C) ice horizons. Calculated virus-bacteria contact rates in underlying -1 degrees C seawater were similar to those in brines of -11 degrees C ice but up to 600 times lower than those in ice brines at or below -24 degrees C. We then incubated native bacterial and viral assemblages from winter sea ice for 8 days in brine at a temperature (-12 degrees C) and salinity ( approximately 160 psu) near expected in situ values, monitoring their concentrations microscopically. While different cores yielded different results, consistent with known spatial heterogeneity in sea ice, these experiments provided unambiguous evidence for viral persistence and production, as well as for bacterial growth, in -12 degrees C brine.

Arctic Regions↗

Ice cream headache--site, duration, and relationship to migraine.

OBJECTIVE: To examine the characteristics of cold-induced headaches in a group of migraine patients, to compare these with their usual migraine headaches and with cold-induced headaches in a control population. DESIGN: Subjects completed a structured questionnaire recording previous headache history along with the characteristics of any headache produced during supervised palatal and pharyngeal application of ice cream. SUBJECTS: 70 consecutive patients attending the City of London Migraine Clinic, and 50 pre-clinical medical and dental student volunteers from Queen Mary and Westfield College. RESULTS: 27% of the migraine patients and 40% of the students reported previous ice cream headaches. 17% of the migraine patients and 46% of the students developed headache following palatal application or a swallow of ice cream. Typically the headache was of early onset (x = 12.5s) and short duration (x = 21s), with a tendency for anterior headache on the same side as a palatal stimulus, and bilateral headache following an ice cream swallow. However, a significant minority experienced a previously unreported headache of late onset (x = 102s) and long duration (x = 236s) which tended to occur particularly after swallowing ice cream and to be less well localised to the side of the cold stimulus. Ice cream appeared not to be a common trigger for migraine, and there was no significant correlation between site of ice cream headache and usual site of migraine. CONCLUSIONS: These findings confirm that cold stimulation of the palate or pharynx commonly produces a headache. In contrast to previous studies, our results suggest that the 'ice cream headache' is less common in migraine patients than the general population. A similar pattern of headache was produced in both migraine patients and controls, and apart from the few for whom an ice cream headache may trigger a migraine, the ice cream headache seems not to have any special significance for migraine patients.

Adolescent↗

Formation of bacterial membrane ice-nucleating lipoglycoprotein complexes.

The preliminary finding that nonprotein additions to the protein product of the ice-nucleating gene of Pseudomonas syringae or Erwinia herbicola are essential for ice nucleation at the warmest temperatures has led to experiments aimed at identifying possible linkages between the ice protein and the other components. It appears that the protein is coupled to various sugars through N- and O-glycan linkages. Mannose residues are apparently bound via an N-glycan bond to the amide nitrogen of one or more of the three essential asparagine residues in the unique amino-terminal portion of the protein. In turn, these mannose residues are involved in the subsequent attachment of phosphatidylinositol to the nucleation structure. This phosphatidylinositol-mannose-protein structure is the critical element in the class A nucleating structure. In addition to sugars attached to the asparagine residues, additional sugar residues appear to be attached by O-glycan linkages to serine and threonine residues in the primary repeating octapeptide, which makes up 70% of the total ice protein. These additional sugar residues include galactose and glucosamine and most likely additional mannose residues. These conclusions were based on (i) the changes in ice-nucleating activity due to the action of N- and O-glycanases, alpha- and beta-mannosidoses, and beta-galactosidase; (ii) immunoblot analyses of ice proteins in cell extracts after enzyme treatments; and (iii) the properties of transformed Ice+ Escherichia coli cells containing plasmids with defined amino-terminal and carboxyl-terminal deletions in the ice gene. Finally, evidence is presented that these sugar residues may play a role in aggregating the ice gene lipoglycoprotein compound into larger aggregates, which are the most effective ice nucleation structures.

Bacterial Outer Membrane Proteins↗

Why does insect antifreeze protein from Tenebrio molitor produce pyramidal ice crystallites?

The antifreeze protein (AFP) reduces the growth rates of the ice crystal facets. In that process the ice morphology undergoes a modification. An AFP-induced surface pinning mechanism, through matching of periodic bond chains in two dimensions, enables two-dimensional regular ice-binding surfaces (IBSs) of the insect AFPs to engage a certain class of ice surfaces, called primary surfaces. They are kinetically stable surfaces with unambiguous and predetermined orientations. In this work, the orientations and molecular compositions of the primary ice surfaces that undergo growth rate reduction by the insect AFPs are obtained from first principles. Besides the basal face and primary prism, the ice surfaces engaged by insect AFPs include the specific ice pyramids produced by the insect AFP Tenebrio molitor (TmAFP). TmAFP-induced pyramids differ fundamentally from the ice pyramids produced by fish AFPs and antifreeze protein glycoproteins (AFPGs) as regards the ice surface configurations and the mode of interaction with the protein IBS. The molecular compositions of the TmAFP-induced pyramids are strongly bonded in two dimensions and have the constant face indices (101). In contrast, the molecular composition of the ice pyramids produced by fish AFPs and AFPGs are strongly bonded in only one direction and have variable face indices (h 0 l), none of which equal (101). The thus far puzzling behavior of the TmAFP in producing pyramidal crystallites is fully explained in agreement with experiment.

Animals↗

Numerical investigations of future ice conditions in the Baltic Sea.

Global climate changes is expected to have an effect on the physical and ecological characteristics of the Baltic Sea. Estimates of future climate on the regional scale can be obtained by using either statistical or dynamical downscaling methods of global AOGCM scenario results. In this paper, we use 2 different coupled ice-ocean models of the Baltic Sea to simulate present and future ice conditions around 100 years from present. Two 10-year time slice experiments have been performed using the results of atmospheric climate model simulations as forcing, one representing pre-industrial climate conditions (control simulation), and the other global warming with a 150% increase in CO2 greenhouse gas concentration (scenario simulation). Present-day climatological ice conditions and interannual variability are realistically reproduced by the models. The simulated range of the maximum annual ice extent in the Baltic in both models together is 180 to 420 x 10(3) km2 in the control simulation and 45 to 270 x 10(3) km2 in the scenario simulation. The range of the maximum annual ice thickness is from 32 to 96 cm and from 11 to 60 cm in the control and scenario simulations, respectively. In contrast to earlier estimates, sea ice is still formed every winter in the Northern Bothnian Bay and in the most Eastern parts of the Gulf of Finland. Overall, the simulated changes of quantities such as ice extent and ice thickness, as well as their interannual variations are relatively similar in both models, which is remarkable, because the 2 coupled ice-ocean model systems have been developed independently. This increases the reliability of future projections of ice conditions in the Baltic Sea.

Baltic States↗

Phospholipid requirement for expression of ice nuclei in Pseudomonas syringae and in vitro.

Delipidation of partially purified outer membranes of Pseudomonas syringae by various delipidating agents resulted in a significant loss of ice nucleation activity associated with the cell envelopes of this and other ice nucleation active bacteria. Lipopolysaccharide depletion of such membranes caused no reduction in ice nucleation activity. Both phospholipid content and ice nucleation activity of membranes were decreased by a similar fractional amount with time after treatment with phospholipase A2. A proportional quantitative relationship between loss of ice nucleation activity and lipid removal with increasing concentrations of sodium cholate and sodium dodecyl sulfate (SDS) was also observed. Significant linear relationships between the amount of lipid removed by phospholipase A2, sodium cholate, and SDS and the loss of ice nucleation activity in P. syringae outer membranes were observed. However, the slopes of these linear relationships for membranes treated with phospholipase A2 (m = 0.80), SDS (m = 0.94), and sodium cholate (m = 0.53) differed. The lower slope value for cholate-treated membranes indicated a partial substitution of sodium cholate for the phospholipids removed. The ice nucleation activity of delipidated outer membranes was restored by reconstitution with various phospholipids in a cholate dialysis procedure. Lipid classes differed in their ability to restore ice nucleation activity to sodium cholate-treated outer membranes. These results suggest that a hydrophobic environment provided either by lipids or certain detergent micelles is required for proper assembly and structural organization of an oligomeric ice protein complex enabling its expression as an ice nucleus.

Cell Membrane↗

Laser ablation inductively coupled plasma mass spectrometry: a new tool for trace element analysis in ice cores.

A new method for the detection of trace elements in polar ice cores using laser ablation with subsequent inductively coupled plasma mass spectrometry analysis is described. To enable direct analysis of frozen ice samples a special laser ablation chamber was constructed. Direct analysis reduces the risk of contamination. The defined removal of material from the ice surface by means of a laser beam leads to higher spatial resolution (300-1000 microm) in comparison to investigations with molten ice samples. This is helpful for the detection of element signatures in annual layers of ice cores. The method was applied to the successful determination of traces for the elements Mg, Al, Fe, Zn, Cd, Pb, some rare-earth elements (REE) and minor constituents such as Ca and Na in ice cores. These selected elements serve as tracer elements for certain sources and their element signatures detected in polar ice cores can give hints to climate changes in the past. We report results from measurements of frozen ice samples, the achievable signal intensities, standard deviations and calibration graphs as well as the first signal progression of 205Pb in an 8,000-year-old ice core sample from Greenland. In addition, the first picture of a crater on an ice surface burnt by an IR laser made by cryogenic scanning electron microscopy is presented.

Journal Article↗

Evaluation of depth profiling using laser resonant desorption as a method to measure diffusion coefficients in ice.

Diffusion of gases in ice is involved in cloud, snow, and ice core chemistry, but few data exist on the relevant diffusion coefficients. A novel method to measure diffusion coefficients in ice has recently been proposed by Livingston et al. (Anal. Chem., 2000, 72, 5590-5599). It is based on depth profiling of doped ice crystals epitaxially grown on Ru(001) by laser resonant desorption (LRD). Using this method, Livingston et al. obtained a value of the diffusion coefficient of the HCl hydrate in ice at 190 K of about 5 x 10(-11) cm2/s. We argue here that this value is many orders of magnitude higher than what could be expected from literature values, which are not reported in sufficient detail by Livingston et al. We investigate the possibilities that their high value could be due to (1) diffusion in defects in the ice, which would be present in very high concentrations because of the ice growth method; and (2) the fact that diffusion of high concentrations of HCl in ice at 190 K forms an amorphous HCl:H2O solid mixture, where HCl diffusion is fast. We present new infrared spectroscopic data on solid HCl:H2O mixtures that confirm that such mixtures can indeed be formed in an amorphous state at 190 K. Our proposed interpretation is that by depositing large amounts of HCl on epitaxially grown ice, Livingston et al. created a superficial amorphous binary mixture and that fast diffusion of HCl in the ice, possibly accelerated by a high defect density, produced an amorphous HCl:H2O mixture. We conclude that the processes studied by Livingston et al. are different from those involved in the atmospheric and cryospheric sciences, and that their data, obtained by depth profiling using LRD, probably cannot be applied to those fields.

Journal Article↗

Adsorption study of acetone on acid-doped ice surfaces between 203 and 233 K.

Adsorption studies of acetone on pure ice surfaces obtained by water freezing or deposition or on frozen ice surfaces doped either with HNO3 or H2SO4 have been performed using a coated wall flow tube coupled to a mass spectrometric detection. The experiments were conducted over the temperature range 203-233 K and freezing solutions containing either H2SO4 (0.2 N) or HNO3 (0.2-3 N). Adsorption of acetone on these ice surfaces was always found to be totally reversible whatever were the experimental conditions. The number of acetone molecules adsorbed per ice surface unit N was conventionally plotted as a function of acetone concentration in the gas phase. For the same conditions, the amount of acetone molecules adsorbed on pure ice obtained by deposition are about 3-4 times higher than those measured on frozen ice films, H2SO4-doped ice surfaces lead to results comparable to those obtained on pure ice. On the contrary, N increases largely with increasing concentrations of nitric acid in ice surfaces, up to about 300 times under our experimental conditions and for temperatures ranging between 213 and 233 K. Finally, the results are discussed and used to reestimate the partitioning of acetone between the ice and gas phases in clouds of the upper troposphere.

Journal Article↗

Kinetics of ClONO(2) reactive uptake on ice surfaces at temperatures of the upper troposphere.

The reactive uptake kinetics of ClONO(2) on pure and doped water-ice surfaces have been studied using a coated wall flow tube reactor coupled to an electron impact mass spectrometer. Experiments have been conducted on frozen film ice surfaces in the temperature range 208-228 K with P((ClONO)(2)) < or = 10(-6) Torr. The uptake coefficient (gamma) of ClONO(2) on pure ice was time dependent with a maximum value of gamma(max) approximately 0.1. On HNO(3)-doped ice at 218 K the gamma(max) was 0.02. HOCl formation was detected in both experiments. On HCl-doped ice, uptake was gas-phase diffusion limited (gamma > 0.1) and gas-phase Cl(2) was formed. The uptake of HCl on ice continuously doped with HNO(3) was reversible such that there was no net uptake of HCl once the equilibrium surface coverage was established. The data were well described by a single site 2-species competitive Langmuir adsorption isotherm. The surface coverage of HCl on HNO(3)-doped ice was an order of magnitude lower than on bare ice for a given temperature and P(HCl). ClONO(2) uptake on this HCl/HNO(3)-doped ice was studied as a function of P(HCl). gamma(max) was no longer gas-phase diffusion limited and was found to be linearly dependent on the surface concentration of HCl. Under conditions of low HCl surface concentration, hydrolysis of ClONO(2) and reaction with HCl were competing such that both Cl(2) and HOCl were formed. A numerical model was used to simulate the experimental results and to aid in the parametrization of ClONO(2) reactivity on cirrus ice clouds in the upper troposphere.

Journal Article↗

Diffusion of HDO in pure and acid-doped ice films.

In these experiments, a few bilayers of D(2)O were vapor-deposited on a pure crystalline H(2)O ice film or an ice film doped with a small amount of HCl. Upon deposition, H/D isotopic exchange quickly converted the D(2)O layer into an HDO-rich mixture layer. Infrared absorption spectroscopy followed the changes of the HDO from the initial HDO mixture layer to HDO isolated in the H(2)O ice film. This was possible because isolated HDO in H(2)O ice has a unique, sharp peak in the O-D stretch region that can be distinguished from the broad peak due to the initial HDO mixture layer. The absorbance of isolated HDO displayed first-order kinetics and was attributed to diffusion of HDO from the HDO-rich mixture layer into the underlying H(2)O ice film. While negligible diffusion was observed for pure ice films and for ice films with HCl concentrations up to 1 x 10(-4) mole fraction, diffusion of HDO occurred for higher concentrations of (2-20) x 10(-4) mole fraction HCl with a concentration-independent rate constant. The diffusion under these conditions followed Arrhenius behavior for T = 135-145 K yielding E(a) = 25 +/- 5 kJ/mol. The mechanism for the HDO diffusion involves either (i) molecular self-diffusion or (ii) long-range H/D diffusion by a series of multiple proton hop and orientational turn steps. While these spectroscopic results compare favorably with recent studies of molecular self-diffusion in low-temperature ice films, the diffusion results from all the ice film studies at low temperatures (ca. T < 170 K) differ from earlier bulk ice studies at higher temperatures (ca. T > 220 K). A comparison and discussion of the various diffusion studies are included in this report.

Journal Article↗

High interannual variability of sea ice thickness in the Arctic region.

Possible future changes in Arctic sea ice cover and thickness, and consequent changes in the ice-albedo feedback, represent one of the largest uncertainties in the prediction of future temperature rise. Knowledge of the natural variability of sea ice thickness is therefore critical for its representation in global climate models. Numerical simulations suggest that Arctic ice thickness varies primarily on decadal timescales owing to changes in wind and ocean stresses on the ice, but observations have been unable to provide a synoptic view of sea ice thickness, which is required to validate the model results. Here we use an eight-year time-series of Arctic ice thickness, derived from satellite altimeter measurements of ice freeboard, to determine the mean thickness field and its variability from 65 degrees N to 81.5 degrees N. Our data reveal a high-frequency interannual variability in mean Arctic ice thickness that is dominated by changes in the amount of summer melt, rather than by changes in circulation. Our results suggest that a continued increase in melt season length would lead to further thinning of Arctic sea ice.

Journal Article↗

The formation of cubic ice under conditions relevant to Earth's atmosphere.

An important mechanism for ice cloud formation in the Earth's atmosphere is homogeneous nucleation of ice in aqueous droplets, and this process is generally assumed to produce hexagonal ice. However, there are some reports that the metastable crystalline phase of ice, cubic ice, may form in the Earth's atmosphere. Here we present laboratory experiments demonstrating that cubic ice forms when micrometre-sized droplets of pure water and aqueous solutions freeze homogeneously at cooling rates approaching those found in the atmosphere. We find that the formation of cubic ice is dominant when droplets freeze at temperatures below 190 K, which is in the temperature range relevant for polar stratospheric clouds and clouds in the tropical tropopause region. These results, together with heat transfer calculations, suggest that cubic ice will form in the Earth's atmosphere. If there were a significant fraction of cubic ice in some cold clouds this could increase their water vapour pressure, and modify their microphysics and ice particle size distributions. Under specific conditions this may lead to enhanced dehydration of the tropopause region.

Journal Article↗

A reexamination of the ice III/IX hydrogen bond ordering phase transition.

Ice III is a hydrogen bond disordered crystal which when cooled 1 K / min or faster transforms to an antiferroelectric hydrogen bond ordered structure, ice IX. Throughout its region of stability, experiments indicate that the H bonds in ice III are, in fact, partially ordered, i.e., some proton arrangements are preferred. In addition, there has been evidence that the structure of ice IX retains some residual disorder after the transition. Diffraction experiments and calorimetry apparently conflict with regard to the degree of ordering at the ice III/IX transition. Mean field statistical mechanical theories have been used to link partial occupations from diffraction data with thermodynamics. In this work, we investigate the ice III/IX proton ordering phase transition using electronic density functional theory calculations for small unit cells, extended to simulate the phase transition in a large unit cell using graph invariants. In agreement with experiment, we observe partial ordering over a wide range of temperatures as ice III transforms to partially disordered ice IX, near 126 K, which becomes fully ordered at lower temperatures. We compare our results from full statistical mechanical simulations with mean field models, finding small errors for the low-temperature ice IX phase and much larger errors for the high-temperature ice III phase. The failure of mean field theories may explain the apparent conflict between diffraction experiments and calorimetry.

Journal Article↗

Outpatient-based ifosfamide, carboplatin and etoposide (ICE) chemotherapy in transplant-eligible patients with non-Hodgkin's lymphoma and Hodgkin's disease.

We have treated 38 transplant-eligible patients with relapsed/refractory non-Hodgkin's lymphoma and Hodgkin's disease using an outpatient-based regimen of ifosfamide, carboplatin and etoposide (ICE) for both salvage and peripheral blood stem cell mobilisation. Patients included relapsed or refractory diffuse large B-cell lymphoma (n = 17), follicular lymphoma (n = II), T-cell lymphoma (n = 2), mantle cell lymphoma (n = 2) and Hodgkin's disease (n = 6). Seven patients with diffuse large B-cell lymphoma and three patients with follicular lymphoma (26%) were considered chemorefractory. Cycles of ICE therapy were administered every 21 days as an outpatient and consisted of ifosfamide 5000 mg/m2 intravenously (i.v.) fractionated into three equally divided doses over 3 days, carboplatin [mg dose = 5 x area under the curve (AUC)] i.v. on day 1 and etoposide 100 mg/m2- i.v. daily for 3 days. Subsequently. granulocyte colony-stimulating factor (G-CSF)5 microg/kg subcutaneously (s.c.) was administered daily from day +5. Of the I I follicular lymphoma patients, 10 also received rituximab with ICE therapy. Median age of patients was 52 years (range 30-65). Patients received a mean of 2.6 cycles (range 1-4) of ICE. There were no toxic deaths and no significant non-haematological toxicities secondary to ICE therapy. Grade IV thrombocytopenia and grade IV neutropenia with at least one cycle of ICE were seen in 47% and 53% of patients, respectively. Median time to peripheral blood stem cell (PBSC) harvest was 14 days (range 10-20). while the median CD34+ cell yield was 5.2 x 10(6) cells/kg(range 2.3 x 10(6)-27.2 x 10(6)). Only one of the ICE-responders failed to mobilise PBSCs. The overall response rate to ICE was 87%. comprising 14 patients (37%) who achieved a complete response (CR) and 19 (50%) who achieved a partial response (PR). A total of 30 patients have undergone autologous stem cell transplantation(SCT) while two follicular lymphoma patients have received a non-myeloablative allogeneic SCT. Follow-up is short: however, the Kaplan-Meier estimate of the proportion of patients alive and event-free at a median follow-up of 11 months is 80% and 59%, respectively. Event-free survival for patients who achieved a CR after ICE and transplantation is 88% versus 45% for those who achieved a PR. These data confirm the efficacy and tolerability of fractionated ICE chemotherapy as both a salvage and mobilisation regimen that can be readily delivered in an outpatient setting.

Adult↗