A Randomized Phase III Trial Comparing Early High Dose Chemotherapy and an Autologous Stem Cell Transplant to Conventional Dose ABVD Chemotherapy for Patients With Advanced Stage Poor Prognosis Hodgkin's Disease as Defined by the International Prognostic Factors Project on Advanced Hodgkin's Disease

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed stage III or IV Hodgkin's disease with at least 3 of the
following characteristics:

- Albumin less than 4.0 mg/dL

- Hemoglobin less than 10.5 g/dL

- Leukocytosis at least 15,000/mm^3

- Lymphocytopenia less than 600/mm^3 or less than 8% of total WBC

- Male sex

- At least 45 years of age

- Stage IV disease

- Bidimensionally measurable disease

- Bilateral or unilateral bone marrow aspiration and biopsy performed within 42 days of
study

- Negative chest x-ray within 42 days of study OR

- Chest x-ray performed within 28 days of study

- Negative CT scan of thorax, abdomen, and pelvis within 42 days of study OR

- CT scan of thorax, abdomen, and pelvis performed within 28 days of study

- No history of lymphoma, myelodyplastic syndrome, or leukemia

- No CNS involvement by Hodgkin's disease

PATIENT CHARACTERISTICS:

Age:

- 15 to 65

Performance status:

- Zubrod 0-1

Life expectancy:

- Not specified

Hematopoietic:

- See Disease Characteristics

Hepatic:

- See Disease Characteristics

- Bilirubin no greater than 1.5 times upper limit of normal (ULN) (unless elevation due
to liver infiltration by Hodgkin's disease)

- Lymphoma-related hepatic dysfunction allowed

Renal:

- Creatinine no greater than 2.0 times ULN

- Creatinine clearance at least 60 mL/min

- Lymphoma-related renal dysfunction allowed

Cardiovascular:

- No coronary artery disease, cardiomyopathy, congestive heart failure, or arrhythmias
requiring therapy

- Ejection fraction normal

- No significant EKG abnormalities suggesting active cardiac disease

Pulmonary:

- Corrected DLCO at least 60% OR

- FEV1 at least 60% predicted

Other:

- Not pregnant or nursing

- Fertile patients must use effective contraception

- No HIV or AIDS

- No other prior malignancy within past 5 years except adequately treated basal cell or
squamous cell skin cancer

- No active bacterial, fungal, or viral infection*

- Afebrile for 3 consecutive days* NOTE: *Prior to randomization portion of study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Not specified

Chemotherapy:

- No prior chemotherapy for Hodgkin's disease except single course of ABVD
(doxorubicin, bleomycin, vinblastine, and dacarbazine) within 35 days of study

Endocrine therapy:

- Not specified

Radiotherapy:

- No prior radiotherapy for Hodgkin's disease

Surgery:

- Not specified

Other:

- At least 3 days since prior antibiotics, antifungals, or antivirals (except for
prophylactic therapy or fever associated with underlying lymphoma) (for randomization
portion of study)