Combination Chemotherapy Plus Rituximab in Treating Patients With Relapsed Non-Hodgkin's Lymphoma

OBJECTIVES:

- Determine response rate to cisplatin, cytarabine, and dexamethasone (DHAP) plus
rituximab in patients with relapsed CD20+ B-cell non-Hodgkin's lymphoma.

- Determine the percentage of patients able to proceed to transplant after two courses of
this treatment regimen.

- Determine the duration of response and overall survival of the patients not proceeding
to transplant after two courses of this treatment regimen.

OUTLINE: Patients receive rituximab IV on days 1, 8, 15, and 22 for the first course only.
Patients receive dexamethasone orally or IV on days 1-4, cisplatin IV continuously for 24
hours on day 1, cytarabine IV over 3 hours every 12 hours for 2 doses on day 2, and
sargramostim (GM-CSF) subcutaneously on days 3-12 or until blood counts recover.
Chemotherapy repeats every 21 days for 2 courses in the absence of disease progression or
unacceptable toxicity.

Patients are followed every 3 months for 1 year, every 4 months for 1 year, and then every 6
months for 3 years.

PROJECTED ACCRUAL: A total of 17-50 patients will be accrued for this study within 11
months.

DISEASE CHARACTERISTICS:

- Histologically confirmed CD20+ B-cell non-Hodgkin's lymphoma

- Relapsed following chemotherapy and eligible for platinum-containing regimen

- Measurable disease

- Must be at least 1.5 x 1.5 cm

PATIENT CHARACTERISTICS:

Age:

- 18 and over

Performance status:

- ECOG 0-2

Hematopoietic:

- Absolute neutrophil count at least 1,500/mm^3

- Platelet count at least 75,000/mm^3

Hepatic:

- Bilirubin no greater than 2.0 mg/dL

Renal:

- Creatinine no greater than 1.5 times upper limit of normal

Cardiovascular:

- No uncontrolled hypertension

Other:

- HIV negative

- No other active malignancy

- No uncontrolled diabetes mellitus

- No uncontrolled peptic ulcer disease

- No uncontrolled infection

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception