A Phase II Study Evaluating Three Cyslces of Ifosfamide, Carboplatin, Etoposide, and Rituximab (RICE) Followed by Two Cycles of Gallium Nitrate, Rituximab and Dexamethasone (GARD) for Relapsed or Refractory Diffuse Large B-Cell Lymphoma MA

Inclusion Criteria:

- Must have histologically or cytologically confirmed diffuse, large B-cell lymphoma
(WHO classification diffuse large B-cell lymphoma or mediastinal large B-cell
lymphoma), immunoblastic B cell lymphoma or Burkitts lymphoma. Transformed, large
B-cell lymphoma will be excluded.

- Must have measurable disease, defined as at least one lesion that can be accurately
measured in at least one dimension (longest diameter to be recorded) as >10 mm with
spiral CT scan.

- Must be refractory to initial therapy or have disease relapse from prior therapy and
must be at least 3 weeks post treatment from prior chemotherapy or radiation therapy.

- Age >18 years.

- Life expectancy >24 weeks

- SWOG performance status <1 (Karnofsky >80%).

- Must have normal organ function (or impaired marrow function) as defined below:

- leukocytes > or equal to 1,500/mcL

- absolute neutrophil count >or equal to 1,000/mcL

- platelets >or equal to 50,000/mcL

- total bilirubin within normal institutional limits

- AST(SGOT)/ALT(SGPT) due to lymphoma involvement

- creatinine clearance > than or equal to 60 mL/min

- Must agree not to become pregnant for the duration of study participation.

- Ability to understand and the willingness to sign a written informed consent
document.

Exclusion Criteria:

- Patients who have had chemotherapy or radiotherapy within 3 weeks (6 weeks for
nitrosoureas or mitomycin C) prior to entering the study.

- Follicular B-cell lymphomas, small lymphocytic lymphomas, chronic lymphocytic
leukemia, lymphoblastic lymphomas and all T-cell lymphomas.

- Patients may not be receiving any other investigational agents, within trials in the
previous 4 weeks.

- Patients with known CNS metastases are excluded from this clinical trial.

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to gallium nitrate, rituximab, dexamethasone, ifosfamide, carboplatin,
and/or etoposide.

- Prior therapy with gallium nitrate, ifosfamide, carboplatin and/or etoposide

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements.

- Pregnant and women who are nursing are excluded from this study.

- Because patients with immune deficiency are at increased risk of lethal infections
when treated with marrow-suppressive therapy, HIV-positive patients receiving
combination anti-retroviral therapy are excluded from the study because of possible
pharmacokinetic interactions with RICE and/or GaRD.