Pegfilgrastim and Combination Chemotherapy With or Without Rituximab in Treating Older Patients With Aggressive B-Cell Non-Hodgkin Lymphoma
Lymphoma
About this trial
This is an interventional treatment trial for Lymphoma focused on measuring stage III grade 3 follicular lymphoma, stage I adult lymphoblastic lymphoma, stage III adult lymphoblastic lymphoma, stage IV adult lymphoblastic lymphoma, contiguous stage II adult lymphoblastic lymphoma, noncontiguous stage II adult lymphoblastic lymphoma, anaplastic large cell lymphoma, stage III adult diffuse large cell lymphoma, stage I adult diffuse large cell lymphoma, stage IV adult diffuse large cell lymphoma, contiguous stage II adult diffuse large cell lymphoma, contiguous stage II adult immunoblastic large cell lymphoma, noncontiguous stage II adult diffuse large cell lymphoma, noncontiguous stage II adult immunoblastic large cell lymphoma, stage III adult immunoblastic large cell lymphoma, stage I adult immunoblastic large cell lymphoma, stage IV adult immunoblastic large cell lymphoma, stage III adult Burkitt lymphoma, stage IV adult Burkitt lymphoma, stage III mantle cell lymphoma, stage I mantle cell lymphoma, contiguous stage II mantle cell lymphoma, noncontiguous stage II mantle cell lymphoma, stage I adult Burkitt lymphoma, contiguous stage II adult Burkitt lymphoma, noncontiguous stage II adult Burkitt lymphoma, stage III marginal zone lymphoma, stage IV marginal zone lymphoma, stage I marginal zone lymphoma, contiguous stage II marginal zone lymphoma, noncontiguous stage II marginal zone lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS:
Diagnosis of CD20-positive B-cell non-Hodgkin lymphoma (NHL)
- Confirmed by an excisional biopsy of a lymph node or by a sufficiently extensive biopsy of an extranodal involvement (if there is no lymph node involvement)
- Results of the immunohistological analysis of expression of the CD20 antigen by lymphoma cells must be obtained
Aggressive disease, including any of the following B-cell NHL
- Stage III follicular lymphoma
- Stage III follicular lymphoma and diffuse B-cell lymphoma
- Lymphoblastic precursor B-cell lymphoma
Diffuse large B-cell lymphoma, including any of the following subtypes:
- Centroblastic
- Immunoblastic
- Plasmablastic
- Anaplastic large cell
- T-cell rich B-cell lymphoma
- Primary effusion lymphoma
- Intravasal B-cell lymphoma
- Primary mediastinal B-cell lymphoma
- Mantle zone lymphoma
- Burkitt or Burkitt-like lymphoma
- Aggressive marginal zone lymphoma (monocytoid)
All risk group allowed
- Age adjusted IPI 0-3
- Previously untreated disease
PATIENT CHARACTERISTICS:
- ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
- No other serious concurrent diseases
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Arm I (without rituximab)
Arm II (with rituximab)
Patients receive pegfilgrastim subcutaneously (SC) on day 2 or 4 and CHOP comprising cyclophosphamide IV, doxorubicin IV, vincristine IV on day 1, and oral prednisone on days 1-5. Treatment repeats every 2 weeks for up to 6-8 courses in the absence of disease progression or unacceptable toxicity.
Patients receive pegfilgrastim and CHOP for up to 6-8 courses as in arm I. They also receive rituximab (administered 2 hours before beginning CHOP) on day 1. Treatment with rituximab repeats every 2 weeks for up to 8 courses.