Combination Chemotherapy in Treating Patients With Aggressive Non-Hodgkin's Lymphoma

DISEASE CHARACTERISTICS:

• Histologically proven previously untreated bulky stage IA or stage IB-IV aggressive non-Hodgkin's lymphoma of 1 of the following types:

  • Working formulation:

    • Follicular large cell
    • Diffuse mixed cell
    • Diffuse large cell
    • Diffuse immunoblastic OR

  • REAL classification:

    • Diffuse large B-cell
    • Peripheral T-cell
• Measurable or evaluable disease

• Good prognosis defined as no more than one of the following:

  • Stage III/IV disease
  • LDH greater than upper limit of normal
  • ECOG/WHO 2-4
• No lymphoblastic or Burkitt's lymphoma
• No CNS involvement

PATIENT CHARACTERISTICS:

Age:

• 18 to 59

Performance status:

• See Disease Characteristics

Life expectancy:

• Not specified

Hematopoietic:

• Hemoglobin at least 10 g/dL
• Neutrophil count at least 2,000/mm3
• Platelet count at least 100,000/mm3

Hepatic:

• Bilirubin, AST, and ALT no greater than 1.5 times upper limit of normal

Renal:

• Creatinine no greater than 1.7 mg/dL

Cardiovascular:

• Ejection fraction at least 50% unless dysfunction attributable to lymphoma

Other:

• Not pregnant or nursing
• Fertile patients must use effective contraception
• No other concurrent serious uncontrolled medical conditions
• No other prior malignancy except adequately treated nonmelanoma skin cancer or cervical intraepithelial neoplasia

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior chemotherapy

Endocrine therapy:

• Not specified

Radiotherapy:

• No prior radiotherapy to more than 35% of hematopoietic sites
• Concurrent consolidation radiotherapy allowed

Surgery:

• Not specified