Positron Emission Tomography Using Fludeoxyglucose F 18 in Predicting Response to Treatment in Patients Who Are Receiving Rituximab and Combination Chemotherapy for Newly Diagnosed Non-Hodgkin's Lymphoma

DISEASE CHARACTERISTICS:

• Histologically confirmed newly diagnosed non-Hodgkin's lymphoma (NHL)

  • Intermediate- or high-grade disease
  • Stage I-IV disease

  • Any of the following subtypes are allowed:

    • Diffuse large B-cell lymphoma
    • Anaplastic large cell lymphoma
    • Mantle cell lymphoma
    • Grade 3 follicular lymphoma
    • Mediastinal B-cell lymphoma

  • The following subtypes are not allowed:

    • Lymphoblastic lymphoma
    • Mycosis fungoides/Sézary's syndrome
    • HTLV-1 associated T-cell leukemia or lymphoma
    • Primary CNS lymphoma
    • HIV-associated lymphoma
    • Transformed lymphoma
    • Burkitt's lymphoma

• Adequate staging of lymphoma by any of the following methods:

  • CT scan or MRI of affected sites
  • Unilateral or bilateral bone marrow biopsy
  • Positive pre-treatment positron emission tomography (PET) scan
  • Lumbar puncture
• Radiographically measurable disease by PET scan
• Any International Prognostic Index risk category allowed
• No prior diagnosis of another hematologic malignancy NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology.

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• Not specified

Life expectancy

• Not specified

Hematopoietic

• Absolute neutrophil count > 1,000/mm^3*
• Platelet count ≥ 75,000/mm^3* NOTE: *Unless due to NHL

Hepatic

• Bilirubin ≤ 2.0 mg/dL* (excluding Gilbert's disease) NOTE: *Unless due to NHL

Renal

• Creatinine ≤ 2.0 mg/dL (unless due to NHL)

Cardiovascular

• Ejection fraction ≥ 45% by echocardiogram or MUGA

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• HIV negative
• No other malignancy within the past 5 years except superficial nonmelanoma skin cancer or carcinoma in situ of the cervix
• No other serious co-morbid disease that would preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No prior rituximab for NHL
• No concurrent filgrastim [G-CSF] during course 1 of study treatment except for patients > 70 years of age OR patients with active infection

Chemotherapy

• No prior chemotherapy for NHL

Endocrine therapy

• No prior steroids for NHL

Radiotherapy

• No prior radiotherapy for NHL
• Concurrent consolidation radiotherapy to sites of bulky disease allowed at the discretion of the attending physician

Surgery

• Not specified

Other

• No other prior treatment for NHL