Rituximab and Combination Chemotherapy in Treating Patients With Stage II, Stage III, or Stage IV Diffuse Large B-Cell Non-Hodgkin's Lymphoma

INCLUSION CRITERIA:

   - Diffuse large B-cell non-Hodgkin's lymphoma

      - Bulky stage II (bulk defined as any lesion ≥ 10 cm) or stage III or IV disease

      - The following lymphoma types are excluded:

         - Primary central nervous system lymphoma

         - Transformed low-grade lymphoma (prior history of low-grade lymphoma or clear
         presence of low-grade lymphoma on histologic sections)

         - Primary mediastinal B-cell lymphoma or testicular lymphoma (consolidative
         radiotherapy is usually indicated)

         - Immunodeficiency-related lymphoma (i.e., after organ or bone marrow
         transplant)

   - Measurable disease

      - Patient must have at least one objective measurable disease site (i.e.,
      measurable in at least 2 perpendicular parameters)

      - Measurable disease in the liver is required if the liver is the only site of
      lymphoma involvement

      - Abnormal positron emission tomography scans will not constitute evaluable
      disease, unless verified by CT scan or other appropriate imaging

   - Eastern Cooperative Oncology Group (ECOG) performance status 0-3

   - For patients > 50 years of age, a normal ejection fraction by ECHO or Multigated
   Acquisition Scan (MUGA) is required within 6 weeks prior to registration

   - Absolute neutrophil count ≥ 1,500/mm^3

   - Platelet count > 100,000/mm^3

   - Creatinine < 2.0 mg/dL

   - Bilirubin < 2 mg/dL (may be up to 3.0 mg/dL if due to liver involvement by lymphoma)

EXCLUSION CRITERIA:

   - Prior chemotherapy or radiation therapy for lymphoma

   - Prior anthracyclines or platinum compounds used as systemic chemotherapy

   - Prior radiation therapy to the mediastinum or to ≥ 25% of the bone marrow

   - Concurrent pentostatin or trastuzumab (Herceptin®)

   - Pregnant or nursing

   - Prior malignancy within the past 5 years unless it was in situ OR was treated with
   curative intent AND the patient has remained relapse-free

   - HIV positive