Randomized Phase II Study of Dose-Adjusted EPOCH vs. NHL-15 Chemotherapy for Patients With Previously Untreated Aggressive Non-Hodgkin's Lymphoma (NHL)

Inclusion Criteria

DISEASE CHARACTERISTICS: Histologically confirmed stage II, III, or IV non-Hodgkin's
lymphoma (NHL) Diffuse large B-cell lymphoma (including immunoblastic features) OR
Anaplastic large cell lymphoma No mantle cell lymphomas including equivocal B-cell
lymphomas that are CD5+ and CD23-, have t(11;14), or express markers of mantle cell
lymphoma or other subtypes No low-grade lymphoma (e.g., follicular center cells in bone
marrow) Patients who have 3-5 International Prognostic Index risk factors must have
refused participation in SWOG-S9704/CALGB-59903 trial No known lymphomatous CNS
involvement, including parenchymal or leptomeningeal involvement

PATIENT CHARACTERISTICS: Age: Not specified Performance status: 0-2 Life expectancy: Not
specified Hematopoietic: Absolute neutrophil count at least 1,500/mm3* Platelet count at
least 100,000/mm3* *unless attributable to NHL Hepatic: Bilirubin no greater than 2.0
mg/dL (without Gilbert's disease)* *unless attributable to NHL Renal: Creatinine no
greater than 1.5 mg/dL* *unless attributable to NHL Cardiovascular: LVEF greater than 45%
No ischemic heart disease No myocardial infarction or congestive heart failure in past
year Other: Not pregnant or nursing Fertile patients must use effective contraception HIV
negative

PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior cytotoxic
chemotherapy No other concurrent chemotherapy Endocrine therapy: Prior glucocorticoids
allowed (less than 10 day course) for urgent local disease at diagnosis (e.g., cord
compression, superior vena cava syndrome) No concurrent dexamethasone (except as indicated
by protocol) or other steroidal antiemetics No concurrent hormonal therapy except for
non-disease related conditions Radiotherapy: Prior limited field radiotherapy allowed
Surgery: Not specified