RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
so they stop growing or die. Chemoprotective drugs such as amifostine may protect normal
cells from the side effects of chemotherapy.
PURPOSE: Randomized phase II trial to study the effectiveness of combination chemotherapy
with or without amifostine in treating patients with recurrent or refractory non-Hodgkin's
lymphoma or Hodgkin's disease who are undergoing autologous stem cell transplantation.
OBJECTIVES: I. Evaluate the role of amifostine in reducing hematologic toxicity and
improving mobilization of peripheral progenitor stem cells in patients with recurrent or
refractory non-Hodgkin's lymphoma or Hodgkin's disease who are undergoing platinum based
salvage chemotherapy. II. Evaluate the role of amifostine in preventing renal toxicity in
OUTLINE: This is an randomized, open label study. Patients are randomized to receive salvage
chemotherapy with intravenous dexamethasone/cisplatin/cytarabine (DHAP) with or without
amifostine. Patients receive cisplatin IV over 3 hours followed by cytarabine IV for 2
doses. Patients also receive dexamethasone orally or IV. Treatment repeats every 3-4 weeks
for 2-6 courses. Arm I: Patients receive amifostine IV over 15 minutes prior to all courses
of DHAP, as a 15 minute infusion, beginning 30 minutes prior to cisplatin administration.
Arm II: Patients do not receive amifostine. On day 3 of the last DHAP course, patients
receive filgrastim (G-CSF) until the last day of progenitor stem cell (PSC) mobilization.
PSC transplant continues daily for 4-10 days.
PROJECTED ACCRUAL: A total of 40 patients (20 per treatment arm) will be accrued for this
DISEASE CHARACTERISTICS: Histologically proven recurrent or refractory non-Hodgkin's
lymphoma or Hodgkin's disease requiring salvage chemotherapy Prior treatment with at least
3 courses of first line chemotherapy
PATIENT CHARACTERISTICS: Age: Over 18 Performance Status: ECOG 0-2 Life Expectancy:
Greater than 3 months Hematopoietic: Absolute neutrophil count at least 1,500/mm3 Platelet
count at least 50,000/mm3 Hepatic: Not specified Renal: Creatinine no greater than 1.5
mg/dL Creatinine clearance at least 40 mL/min Cardiovascular: No symptomatic congestive
heart failure (class III or more as defined by American Heart Association) Electrolytes:
Potassium at least 3.4 meq/L Magnesium at least 1.4 meq/L Other: Not pregnant or nursing
PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior high dose
chemotherapy with stem cell transplant At least 3 courses of first line chemotherapy
Endocrine therapy: Not specified Radiotherapy: Not specified Surgery: Not specified