Monoclonal Antibody Therapy, Combination Chemotherapy, and Peripheral Stem Cell Transplant in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma

DISEASE CHARACTERISTICS:

• Diagnosis of non-Hodgkin's lymphoma (NHL) of one of the following types:

  • Diffuse large B-cell
  • Composite (at least 50% of tumor showing diffuse histology)
  • Diffuse mixed cell
  • Immunoblastic
• Relapsed or refractory disease sensitive to initial or subsequent conventional therapy (at least a partial response)
• Eligible for high-dose carmustine, etoposide, cytarabine, and melphalan protocol and autologous bone marrow transplantation or peripheral blood stem cell transplantation
• Evidence of CD20 antigen expression in tumor tissue
• Bidimensionally measurable disease
• No progressive disease in a field that has been previously irradiated with more than 3,500 cGy within the past year

• Adequate peripheral blood stem cells

  • At least 15,000,000 CD34+ cells/kg OR
  • At least 25,000 granulocyte macrophage colony-forming units/kg
• No known brain or leptomeningeal metastases

PATIENT CHARACTERISTICS:

Age:

• 19 to 70

Performance status:

• Karnofsky 70-100%

Life expectancy:

• At least 4 months posttransplantation

Hematopoietic:

• See Disease Characteristics

Hepatic:

• Bilirubin less than 2.0 mg/dL

Renal:

• Creatinine less than 2.0 mg/dL
• No active obstructive hydronephrosis

Cardiovascular:

• Cardiac ejection fraction at least 40% for any of the following criteria:

  • Age 60 and over
  • Significant cardiac history (myocardial infarction or congestive heart failure)
  • Received greater than 350 mg/m^2 of prior doxorubicin
• No New York Heart Association class III or IV heart disease

Pulmonary:

• DLCO at least 50% of predicted

Other:

• No evidence of severe organ dysfunction
• No other major medical illnesses
• No active infection requiring IV antibiotics
• No other malignancy within the past 5 years except adequately treated skin cancer or carcinoma in situ of the cervix
• HIV negative
• Not pregnant
• Negative pregnancy test
• Fertile patients must use effective contraception during and for at least 6 months after study participation
• Human antimouse antibody negative
• No vulnerability

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• See Disease Characteristics
• No prior peripheral blood stem cell transplantation following high-dose chemotherapy or chemoradiotherapy
• At least 4 weeks since prior biologic therapy and recovered
• No other concurrent biologic therapy for NHL

Chemotherapy:

• See Disease Characteristics
• See Biologic therapy
• At least 4 weeks since prior cytotoxic chemotherapy and recovered
• No other concurrent chemotherapy or antineoplastic therapy for NHL

Endocrine therapy:

• No concurrent steroids except maintenance-dose steroids for noncancerous disease

Radiotherapy:

• See Disease Characteristics
• See Biologic therapy
• At least 4 weeks since prior radiotherapy and recovered
• No concurrent external beam radiotherapy for NHL

Surgery:

• Not specified

Other:

• At least 4 weeks since prior immunosuppressants and recovered
• No other concurrent participation on protocol involving non-FDA-approved drugs or biologics