RATIONALE: Radiation therapy uses high-energy x-rays to damage cancer cells. Drugs used in
chemotherapy use different ways to stop cancer cells from dividing so they stop growing or
die. Peripheral stem cell transplantation may allow doctors to give higher doses of
chemotherapy drugs and kill more cancer cells.
PURPOSE: Phase II trial to study the effectiveness of radiation therapy and cyclophosphamide
plus peripheral stem cell transplantation in treating patients who have recurrent or
refractory Hodgkin's disease or non-Hodgkin's lymphoma.
OBJECTIVES: I. Determine the toxicity of autologous peripheral blood stem cell
transplantation following involved field radiotherapy, high dose cyclophosphamide, and total
body irradiation in patients with recurrent or refractory Hodgkin's disease or non-Hodgkin's
lymphoma. II. Determine the response in patients treated with this regimen.
OUTLINE: Patients undergo involved field radiotherapy on days -16 to -7. Patients receive
cyclophosphamide IV over 2 hours on days -6 and -5. Patients undergo total body irradiation
twice daily on days -4 to -1. Autologous peripheral blood stem cells are reinfused on day 0.
Patients are followed every month for 1 year.
PROJECTED ACCRUAL: Not specified
DISEASE CHARACTERISTICS: Histologically proven Hodgkin's disease or non-Hodgkin's lymphoma
that is refractory to standard therapy or has relapsed following initial response Eligible
non-Hodgkin's lymphoma: Low grade Intermediate grade Immunoblastic large cell lymphoma
(high grade) Eligible for involved field radiotherapy, cyclophosphamide, and total body
irradiation No CNS non-Hodgkin's lymphoma or Hodgkin's disease 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: Physiologic age 65 and under Performance status: ECOG 0-2
Life expectancy: At least 2 months Hematopoietic: Not specified Hepatic: Not specified
Renal: Creatinine less than 1.5 mg/dL OR Creatinine clearance greater than 50 mL/min if
creatinine 1.5-2 mg/dL Cardiovascular: No active heart disease (congestive heart failure,
history of myocardial infarction within the past 3 months, or significant arrhythmia)
requiring medication Pulmonary: No nonneoplastic pulmonary disease (e.g., chronic
obstructive pulmonary disease) that would preclude intensive chemotherapy DLCO at least
50% predicted* FEV1 and/or FVC at least 75% predicted* * Unless due to underlying lymphoma
or Hodgkin's disease Other: No other concurrent medical condition that would preclude
aggressive cytotoxic chemotherapy HIV negative No clinical evidence of AIDS
PRIOR CONCURRENT THERAPY: See Disease Characteristics