Response-Based Therapy Assessed By PET Scan in Treating Patients With Bulky Stage I and Stage II Classical Hodgkin Lymphoma

DISEASE CHARACTERISTICS:

• Histologically confirmed* Hodgkin lymphoma

  • Clinical stage IA, IB, IIA, or IIB disease according to the modified Ann Arbor Staging Classification system
  • Subclassified according to the WHO modification of the Rye Classification
  • Patients with "E" extensions are eligible provided all other criteria have been met NOTE: *Patients must submit pathology materials within 60 days of study registration. Core-needle biopsies are acceptable provided they contain adequate tissue for primary diagnosis and immunophenotyping. Fine-needle aspirates are not acceptable. If multiple specimens are available, submit the most recent.
• No nodular lymphocyte-predominant Hodgkin lymphoma
• Has a mediastinal mass > 0.33 maximum intrathoracic diameter on standing postero-anterior chest x-ray or measuring > 10 cm in its largest diameter

PATIENT CHARACTERISTICS:

• Performance status 0-2
• ANC ≥ 1,000/mm^3
• Platelet count ≥ 100,000/mm^3
• Serum creatinine ≤ 2 mg/dL
• Bilirubin ≤ 2 times upper limit of normal (ULN) (in the absence of Gilbert disease)
• AST ≤ 2 times ULN
• LVEF by ECHO or MUGA normal (unless thought to be disease-related)
• DLCO ≥ 60% with no symptomatic pulmonary disease (unless thought to be disease-related)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

• No "currently active" second malignancy other than nonmelanoma skin cancers

  • Patients are not considered to have a "currently active" malignancy if they have completed therapy and are considered by their physician to be at < 30% risk of relapse

• Patients with known HIV are eligible provided their CD4 count is > 350, and they are on concurrent antiretrovirals

  • An HIV test is required for patients with a history of IV drug abuse or any behavior associated with an increased risk of HIV

PRIOR CONCURRENT THERAPY:

• No prior treatment (chemotherapy or radiotherapy) for Hodgkin lymphoma
• No concurrent zidovudine or stavudine as part of the antiretroviral therapy for HIV-positive patients

• No concurrent hormones or other chemotherapeutic agents, except for the following:

  • Steroids for adrenal failure
  • Hormones for non-disease-related conditions (e.g., insulin for diabetes)
  • Dexamethasone on the day of chemotherapy for (acute) chemotherapy-induced nausea or vomiting
• No concurrent intensity-modulated radiation therapy or cobalt-60