Fludeoxyglucose F 18-PET/CT Imaging in Assessing Response to Chemotherapy in Patients With Newly Diagnosed Stage II, Stage III, or Stage IV Hodgkin Lymphoma

DISEASE CHARACTERISTICS:

• Histologically confirmed classical Hodgkin lymphoma (HL) meeting the following criteria:

  • Meets current WHO classification criteria (i.e., nodular sclerosis, mixed cellularity, lymphocyte rich, and lymphocyte-depleted)

  • Clinical stage IIB, III, or IV disease OR clinical stage IIA disease with adverse features, including any of the following:

    • Bulk mediastinal disease, defined as maximal transverse diameter of mass > 0.33 of the internal thoracic diameter at D5/6 interspace on routine chest x-ray
    • Disease outside the mediastinum and lymph node or lymph node mass > 10 cm in diameter
    • More than two sites of disease
    • Other poor-risk features that require treatment with full course combination chemotherapy
• Newly diagnosed disease
• No CNS or meningeal involvement by lymphoma

PATIENT CHARACTERISTICS:

• ECOG performance status 0-3
• Life expectancy > 3 months
• ANC > 1,500/mm^3 (unless there is bone marrow infiltration by lymphoma)
• Platelet count > 100,000/mm^3 (unless there is bone marrow infiltration by lymphoma)
• Creatinine < 150% of upper limit of normal (ULN)
• Bilirubin < 2.0 times ULN (unless attributed to lymphoma)
• Transaminases < 2.5 times ULN (unless attributed to lymphoma)
• LVEF ≥ 50% (in patients with a significant history of ischemic heart disease or hypertension)
• Diffusion capacity within 25% of normal predicted value by lung function testing
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Amenable to the administration of a full course of chemotherapy, according to the investigator
• Must have access to PET/CT scanning
• No poorly controlled diabetes mellitus
• No cardiac contraindication to doxorubicin hydrochloride, including abnormal contractility by ECHO or MUGA
• No neurological contraindication to chemotherapy (e.g., pre-existing neuropathy)
• No other concurrent uncontrolled medical condition
• No other active malignant disease within the past 10 years, except fully excised basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the uterine cervix

• No known positivity for HIV, hepatitis B surface antigen, or hepatitis C

  • Routine testing, in the absence of risk factors, is not required
• No medical or psychiatric condition that compromises the patient's ability to give informed consent

PRIOR CONCURRENT THERAPY:

• No prior chemotherapy, radiotherapy or other investigational drug for HL