Combination Chemotherapy Followed by Donor Stem Cell Transplant in Treating Patients With Relapsed or High-Risk Primary Refractory Hodgkin Lymphoma

DISEASE CHARACTERISTICS:

• Histologically confirmed classical Hodgkin lymphoma, including CD20+ disease

  • No lymphocyte predominant histology

• Primary refractory or relapsed disease with all 3 risk factors, failed platinum-based chemotherapy, or disease relapsed more than 100 days after autologous stem cell transplantation, proven by biopsy or fine-needle aspiration (cytology) of an involved site

  • Risk factors are defined as B-symptoms, extranodal sites of disease, and disease remission lasting < 1 year after first-line therapy
• Failed doxorubicin hydrochloride or mechlorethamine hydrochloride-containing front-line therapy
• Fludeoxyglucose F 18-PET scan demonstrating PET-avid disease
• No more than 2 prior salvage chemotherapy regimens (for patients proceed to allogeneic hematopoietic stem cell transplantation [AHSCT])

• Donor available meeting 1 of the following criteria (for patients proceed to AHSCT):

  • HLA-matched or one allele mismatched related donor

    • Genotypically or phenotypically matched at ≥ 9/10 of the A, B, C, DRB1, and DQB1 loci, as tested by high resolution
    • Peripheral blood stem cells (PBSC) collected

  • HLA-matched unrelated donor

    • Matched at ≥ 9/10 (allele mismatch only) of the A, B, C, DRB1, and DQB1 loci, as tested by high resolution
    • PBSC or bone marrow collected

  • Umbilical cord blood (2 units)

    • must be ≥ 4/6 HLA-A, B antigen, and DRB1 allele matched with recipient

PATIENT CHARACTERISTICS:

• Platelet count > 50,000/mm^3
• ANC > 1,000/mm^3
• Cardiac ejection fraction > 50% (for patients ≥ 18 years of age)
• Fractional shortening > 50% by echocardiogram* (for patients < 18 years of age)
• Adjusted diffusing capacity > 50% on pulmonary function testing*
• Serum creatinine < 1.5 mg/dL
• Creatinine clearance ≥ 50 mL/min
• Total bilirubin < 2.0 mg/dL in the absence of a history of Gilbert disease
• HIV I and II negative
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Karnofsky performance status (PS) ≥ 70% or Lansky PS ≥ 70% (for patients proceed to AHSCT)
• No active and uncontrolled infection at time of transplantation including active infection with Aspergillus or other mold (for patients proceed to AHSCT) NOTE: *measured since last chemotherapy

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior allogeneic transplantation
• No more than 1 prior autologous transplantation
• No inability to complete planned cytoreduction due to therapy complications