Phase II Study Of Dose-Adjusted Epoch-Rituximab (EPOCH-R) Chemotherapy For Patients With Previously Untreated Aggressive CD20+ B-Cell Non-Hodgkin's Lymphoma (NHL)

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed stage II, III, or IV diffuse large cell lymphoma and WHO
variants

- CD20+ large B-cell lymphoma, including those with immunoblastic features

- CD20+ thymic B-cell lymphoma

- No evidence of indolent lymphoma

- No mantle cell lymphomas or equivocal B-cell lymphomas that express markers of
mantle cell lymphoma (e.g., cyclin D) or other subtypes

- No known lymphomatous involvement of the CNS, including the parenchyma or
leptomeninges

PATIENT CHARACTERISTICS:

Age:

- Not specified

Performance status:

- CALGB 0-2

Life expectancy:

- Not specified

Hematopoietic:

- Absolute neutrophil count at least 1,000/mm3*

- Platelet count at least 100,000/mm3* NOTE: * Unless due to lymphoma

Hepatic:

- Bilirubin no greater than 2.0 mg/dL* NOTE: * Unless due to lymphoma or Gilbert's
disease

Renal:

- Creatinine no greater than 1.5 mg/dL* NOTE: * Unless due to lymphoma

Cardiovascular:

- LVEF greater than 45%

- No ischemic heart disease

- No myocardial infarction or congestive heart failure within the past year

Other:

- HIV negative

- Not pregnant or nursing

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Not specified

Chemotherapy:

- No prior cytotoxic chemotherapy

- No other concurrent chemotherapy

Endocrine therapy:

- Prior short-course of glucocorticoids allowed

- No concurrent hormones except for non-disease-related conditions (e.g., insulin for
diabetes)

- No concurrent steroids except for adrenal failure

- No concurrent dexamethasone or other steroidal antiemetics

Radiotherapy:

- Prior limited-field radiotherapy allowed

Surgery:

- Not specified