Pixantrone, Cytarabine, Methylprednisolone, and Cisplatin in Treating Patients With Aggressive Non-Hodgkin’s Lymphoma in First Relapse

DISEASE CHARACTERISTICS:

Histologically confirmed aggressive non-Hodgkin's lymphoma (NHL)

Any stage, with or without B symptoms

The following subtypes are eligible:

Diffuse large cell (B and T cell types)
Anaplastic large cell
Diffuse mixed cell
Immunoblastic large cell
Follicular large cell
Transformed follicular NHL
Diffuse aggressive not otherwise classified
Burkitt-like lymphoma
Bone marrow positive or negative

At least 1 measurable lesion

Patients with bone marrow as the only site of disease are eligible without a measurable lesion
No more than 1 episode of progressive disease, occurring after a response (complete response [CR], complete response unconfirmed [CR_u], or partial response [PR]) to prior chemotherapy* NOTE: *Patients with less than a CR, CRu, or PR and no progression, but who are good candidates for high-dose chemotherapy with stem cell support may be eligible (will be decided on an individual basis)

No chemotherapy-refractory disease, defined as follows:

Stable or progressive disease documented at restaging immediately after the completion of induction therapy
No lymphoblastic lymphoma, or mantle cell lymphoma

PATIENT CHARACTERISTICS:

Age

18 and over

Performance status

WHO 0-1

Life expectancy

At least 3 months

Hematopoietic

Neutrophil count at least 1,500/mm^3*
Platelet count at least 100,000/mm^3* NOTE: *Lower values may be accepted if clearly due to bone marrow involvement by lymphoma

Hepatic

Bilirubin no greater than 1.5 times upper limit of normal (ULN)*
AST or ALT no greater than 2.0 times ULN*
Alkaline phosphatase no greater than 2.0 times ULN*

No history or clinical symptoms of hepatitis B or hepatitis C virus

Patients with seropositivity due to prior vaccination for hepatitis B are eligible NOTE: *Higher values may be accepted if clearly due to liver involvement by lymphoma

Renal

Creatinine no greater than 1.5 mg/dL

Cardiovascular

LVEF at least 50% by MUGA
No clinically significant cardiovascular abnormalities
No New York Heart Association grade II-IV cardiovascular disease
No myocardial infarction within the past 6 months
No severe cardiac arrhythmia
No uncontrolled hypertension

Other

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 6 months after study participation
HIV negative
No clinically significant neurological abnormalities
No condition that would preclude study safety or interfere with study results
No concurrent serious uncontrolled infection

PRIOR CONCURRENT THERAPY:

Biologic therapy

Prior rituximab immediately after the first chemotherapy regimen allowed

Chemotherapy

See Disease Characteristics
See Biologic therapy
At least 6 months since prior anthracycline therapy (e.g., cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP])
More than 2 years since prior fludarabine
More than 2 years since prior nitrosoureas
More than 1 year since prior platinum-based chemotherapy or cytarabine, unless a CR or CR_u was achieved
No prior cumulative dose of cisplatin greater than 600 mg/m^2
No prior single or cumulative dose of doxorubicin greater than 450 mg/m^2

Endocrine therapy

Not specified

Radiotherapy

No prior radiotherapy to the whole pelvis
No prior radioimmunotherapy

Surgery

More than 4 weeks since prior major thoracic and/or abdominal surgery
At least 1 week since prior minor surgery

Other

Recovered from prior therapy

Alopecia allowed
Grade 1 peripheral neuropathy allowed
More than 30 days since prior participation in another investigational drug study
No other concurrent investigational drugs