A Prospective, Comparative Trial of Allogeneic Versus Autologous Stem Cell Transplantation for High Risk Lymphoma

Inclusion Criteria

DISEASE CHARACTERISTICS: Histologically proven non-Hodgkin's lymphoma that has relapsed or
failed to achieve complete remission after first line induction chemotherapy Intermediate
or high grade (including mantle cell, but excluding lymphoblastic disease) No more than 1
prior salvage chemotherapy regimen, e.g.: Dexamethasone, high dose cytarabine, and
cisplatin (DHAP) Etoposide, methylprednisolone, high dose cytarabine, and cisplatin
(ESHAP) Low grade No more than 2 prior salvage chemotherapy regimens, e.g.: Fludarabine,
mitoxantrone, and dexamethasone (FND) ESHAP DHAP OR Histologically proven stage III or IV
Hodgkin's disease that has relapsed or failed to achieve remission after combination
induction chemotherapy Prior primary radiotherapy allowed if relapse is high risk (e.g.,
recurrence in radiation field, B symptoms, liver/marrow involvement) No more than 2 prior
salvage chemotherapy regimens Allogeneic stem cell transplantation group: Availability of
6 antigen (A, B, and DR loci) HLA matched sibling donor No active CNS disease A new
classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The
terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of
"low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former
terminology.

PATIENT CHARACTERISTICS: Age: 15 to 55 Performance status: ECOG 0 or 1 Life expectancy:
Not specified Hematopoietic: Not specified Hepatic: Bilirubin no greater than 2.0 mg/dL
SGOT and SGPT no greater than 3 times normal PT and PTT normal Renal: Creatinine no
greater than 2.0 mg/dL Creatinine clearance at least 60 mL/min Cardiovascular: LVEF at
least 45% by MUGA scan or echocardiogram No myocardial infarction within the past 6 months
No arrhythmias unless medically controlled Pulmonary: FEV1 at least 50% predicted DLCO at
least 50% predicted Other: No diabetes mellitus or thyroid disease unless medically
controlled No active serious infection HIV negative Not pregnant or nursing Negative
pregnancy test

PRIOR CONCURRENT THERAPY: See Disease Characteristics