Bevacizumab and Combination Chemotherapy in Treating Patients With Peripheral T-Cell Lymphoma or Natural Killer Cell Neoplasms

INCLUSION CRITERIA:

Diagnosis of peripheral T-cell or natural killer cell neoplasm

Any stage disease allowed
HTLV-positive tumors allowed
At least one objective measurable disease parameter. Abnormal positron emission tomography scans are not considered evidence of measurable disease unless results are confirmed by CT scan or other appropriate imaging techniques
Age 18 and over
ECOG Performance status 0-2
Absolute neutrophil count ≥ 1,000/mm^3(500/mm^3 if due to bone marrow involvement with lymphoma)
Platelet count ≥ 100,000/mm^3(50,000/mm^3 if due to bone marrow involvement with lymphoma)
Bilirubin ≤ 2.0 mg/dL (≤ 3 times upper limit of normal [ULN] if due to hepatic involvement with lymphoma)
AST ≤ 2 times ULN (5 times ULN if due to hepatic involvement with lymphoma)
PT, INR, and PTT ≤ 1.5 times normal
Creatinine ≤ 2.0 mg/dL
Urinary protein:creatinine ratio ≤ 1
History of deep venous thrombosis allowed provided patient is on a stable dose of anticoagulants for at least 2 weeks prior to study entry
LVEF ≥ 50%
History of pulmonary embolism allowed provided patient is on a stable dose of anticoagulants for at least 2 weeks prior to study entry
One prior cycle of CHOP for PTCL allowed
More than 4 weeks since prior major invasive surgery or open biopsy
At least 7 days since prior minor surgery. Peripheral lymph node core biopsy, bone marrow biopsy, fine needle aspiration, skin biopsy, or central line placement are not considered minor surgical procedures
More than 7 days since prior and no concurrent anti-platelet drugs (e.g., ticlopidine, clopidogrel, or cilostazol) except aspirin or other nonsteroidal anti-inflammatory drugs

Concurrent anticoagulants allowed provided patient is on a stable dose

INR must be stable for at least 2 weeks prior to study entry
PT/INR and/or PTT must be closely monitored and levels kept within acceptable range for underlying thrombotic disease
Concurrent heparin flush for maintenance of central line patency allowed

EXCLUSION CRITERIA:

Anaplastic lymphoma kinase (ALK)-positive T-cell large cell lymphoma. ALK-negative T-cell large cell lymphoma allowed
Cutaneous T-cell lymphoma
History of or current radiographic evidence of CNS metastasis, including previously treated, resected, or asymptomatic brain lesions or leptomeningeal involvement
Evidence of bleeding diathesis or coagulopathy
Cerebrovascular accident within the past 6 months
Myocardial infarction within the past 6 months
Unstable angina within the past 6 months
New York Heart Association class II-IV congestive heart failure
Uncontrolled hypertension (i.e., systolic blood pressure [BP] > 150 mm Hg or diastolic BP > 100 mm Hg)
Other clinically significant cardiovascular or peripheral vascular disease
Abdominal fistula within the past 6 months
Gastrointestinal perforation within the past 6 months
Intra-abdominal abscess within the past 6 months
Concurrent major surgery
Pregnant or nursing. Female patients must have negative pregnancy test. Fertile patients must use effective contraception
History of active seizures
Significant traumatic injury within the past 4 weeks
Non-healing ulcer (unless involved with lymphoma)
Bone fracture
Active infection requiring parenteral antibiotics
HIV positivity
Other active malignancy within the past 6 months except carcinoma in situ of the cervix or basal cell carcinoma of the skin