Combination Chemotherapy and Rituximab in Treating Patients With HIV-Associated Stage I, Stage II, Stage III, or Stage IV Non-Hodgkin's Lymphoma

Inclusion Criteria

• Previously untreated histologically or cytologically documented B-cell non-Hodgkin's lymphoma; the following histologies are eligible: diffuse large B-cell lymphoma, high-grade large cell immunoblastic lymphoma, anaplastic large cell lymphoma, Burkitt's lymphoma, high-grade B-cell lymphoma, Burkitt-like (small non-cleaved lymphoma)
• Tumors must be CD20 positive
• Documented HIV infection: documentation may be serologic (ELISA, western blot), culture, or quantitative PCR or bDNA assays
• Evaluable or measurable disease
• Stage I and IE or Stage II-IV disease patients
• ANC >= 1000 cells/mm^3
• Platelet count >= 75, 000/mm^3 unless cytopenias are secondary to lymphoma
• All patients must be off colony stimulating factor therapy at least 24 hours prior to chemotherapy
• Transaminase = 3.0 due to hepatic involvement the initial dose of doxorubicin will be decreased by 50% and the initial dose of vincristine will be omitted
• Creatinine = 50 (ECOG PS 0, 1, or 2)
• Able to give consent
• Female patients must have a negative pregnancy test within 72 hours of entering into the study; males and females must agree to use adequate birth control if conception is possible during the study; women must avoid pregnancy and men avoid fathering children while in the study
• Patients already receiving erythropoeitin or G-CSF are eligible
• Patients must have a left ventricular ejection fraction that is at or above the lower institutional limits of normal, as assessed by nuclear scan or echocardiogram obtained within 12 weeks of registration
• Lymphomatous meningitis (patients with a positive CSF cytology are eligible)

Exclusion Criteria

• Previous chemotherapy or radiotherapy for this lymphoma
• Primary Central Nervous System Lymphoma (parenchymal brain or spinal cord tumor)
• Acute active HIV-associated opportunistic infection requiring antibiotic treatment; patients with mycobacterium avium are not excluded; chronic therapy with potentially myelosuppressive agents is allowed provided that entry hematologic criteria are met
• Concurrent malignancy (excluding in situ cervical cancer, or non-metastatic non-melanomatous skin cancer, or Kaposi's sarcoma not requiring systemic chemotherapy)
• Previous therapy with rituximab within 12 months; patients treated with rituximab more than 12 months earlier are eligible only if it was given for indications other than the treatment of intermediate- or high-grade lymphoma (eg, low-grade lymphoma or ITP)