MESNA will be administered first as a loading dose 
admixed with ifosfamide over 2 hours (hr 2-4, followed 
immediately by a 3 hour continuous infusion, hr 4-7). At 
completion of the infusion, MESNA is administered every 
3 hours as an intravenous injection over 15 minutes x 6 
doses (hr 7, 10, 13, 16, 19, 22) x 4 days. 
Etoposide will be mixed in 500 ml NS and infused over 90- 
120 minutes (maximum concentration of 1 mg/ml). 
Etoposide will be started prior to the ifosfamide on the 
first day of ICE and continued every 12 hours for 6 doses, 
ending on the third day of ICE. 
CBDCA will be administered as a continuous infusion 
over 72 hours starting on the first day of ICE. A 24-hour 
supply will be placed in 500 ml of D5W and infused 
through the lumen not being used for the 
ifosfamide/mesna. 
Management of fever and neutropenia should be done in 
collaboration with the Infectious Disease team and Dr. 
Wilson. Patients should not be discharged until afebrile 
and an absolute granulocyte count > 500/mm3 x 2 
consecutive days has been achieved. Patients may be 
discharged while still requiring platelet support 
provided there is no clinical bleeding and arrangements 
are made for outpatient platelet support. 
6.10 Bone Marrow Reinfusion 
The bone marrow will be infused 3 days following the 
last ifosfamide dose by the transplant team. All 
patients will have their vital signs monitored q15 
minutes x 4 and q30 minutes x 2. Demerol and benadryl 
are to be used as needed. Hypotension is to be corrected 
with fluid and pulmonary symptoms with 2L/min 
supplemental oxygen. 
Recombinant DNA Research, Volume 16 
