Combination Chemotherapy and Bone Marrow and/or Peripheral Stem Cell Transplantation in Treating Patients With Non-Hodgkin's Lymphoma

• Status: Completed
• Trial end date: 2000-02-01
• Target enrollment: 0
• Participant gender: All

Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Bone marrow and peripheral stem cell transplantation may allow doctors to give high doses of chemotherapy and kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy with cyclophosphamide, etoposide and cisplatin followed by bone marrow and/or peripheral stem cell transplantation in patients with relapsed or refractory intermediate- or high-grade non-Hodgkin's lymphoma.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Temple University
• Treatments: Cisplatin; Cyclophosphamide; Etoposide; Etoposide phosphate

Criteria

DISEASE CHARACTERISTICS:

• Histologically proven relapsed or refractory, stage I-IV, intermediate- or high-grade non-Hodgkin's lymphoma

• Eligible subtypes:

• Diffuse small cleaved cell

• Diffuse mixed (small and large cell)

• Diffuse large cell

• Large cell immunoblastic

• Lymphoblastic

• Small noncleaved cell

• High-grade histology patients should first be considered for Protocol TUHSC-1520

• Must have chemosensitive disease, defined by 1 of the following conditions:

• Response to initial chemotherapy without obtaining complete response (CR)(refractory lymphoma)

• Relapse after chemotherapy-induced CR if tumor volume reduced by at least 25% for more than 1 month after completion of 1-3 courses of salvage chemotherapy (chemosensitive relapse)

• No chemoresistant disease, defined by the following conditions:

• Unresponsive or progressive disease during initial chemotherapy

• Relapse after chemotherapy-induced CR if tumor volume not reduced by at least 25% after completion of 1-3 courses salvage chemotherapy (chemoresistant relapse)

• No CNS involvement by lymphoma

• Syngeneic bone marrow transplantation offered to patients with consenting identical twin donor NOTE: 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 60 (physically fit patients up to age 70 may be considered)

Performance status:

• ECOG 0-2

Life expectancy:

• Not specified

Hematopoietic:

• Not specified

Hepatic:

• Bilirubin no greater than 2.0 mg/dL

• AST and ALT not persistently greater than 2 times normal

Renal:

• Creatinine less than 1.8 mg/dL

Cardiovascular:

• Cardiac ejection fraction at least 45%

Pulmonary:

• DLCO, FEV_1, and FVC at least 50% predicted

• Resting pO_2 at least 70 mm Hg

Other:

• HIV negative

• No other concurrent disease that would limit life expectancy

• No active infection

• No severe neurologic or emotional disorders

• Not pregnant

• Fertile patients must use effective contraception

• Adequate psychological support available

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• See Disease Characteristics

Endocrine therapy

• Not specified

Radiotherapy

• Not specified

Surgery

• Not specified