• Complete response rate [ Time Frame: 6 months post tx ] [ Designated as safety issue: No ]
  

• Progression free survival [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  
• Toxicity [ Time Frame: Ea tx course; q 3 mon for 2 yrs, q6 mon for 3 yrs, q yr for 5 yrs ] [ Designated as safety issue: Yes ]
  

Biological: filgrastim
5 ug/kg/day sub Q injection day 7 until ANC>5000/ul courses II-VII
Biological: rituximab
Day 8 course II 50 mg/sq m IV infusion: d 8 course IV & VI 375mg/sq m IV Day 10 course II: 325 mg/sq m IV infusion Day 12 course II: 375 mg/sq m IV infusion
Drug: cyclophosphamide
200 mg/sq m/day IV infusion over 5-15 min days 1-5, courses I, III, V, VII
Drug: cytarabine
1 g/sq m/day IV infusion Days 4 & 5, courses II, IV, VI
Drug: dexamethasone
10mg/sq m PO or IV Days 1-5 courses II-VII
Drug: doxorubicin hydrochloride
25 mg/sq m/day IV infusion Days 4 & 5 courses III,V, VII
Drug: etoposide
80 mg/sq m/day IV infusion Days 4 & 5 courses II, IV, VI
Drug: ifosfamide
800 mg/sq m/day IV infusion Days 1-5 courses II, IV, VI
Drug: leucovorin calcium
25mg/sq m IV infusion over 15 min then 10 mg IV q 6 hrs until serum MTX <10nM, courses II-VII
Drug: methotrexate
1.5 g/sq m IV infusion Day 1 courses II-VII
Drug: prednisone
60 mg/sq m PO/day Days 1-7 course I
Drug: vincristine sulfate
2 mg IV push Day 1 courses II-VII
Drug: Allopurinol
300 mg/day PO Days 1-14, course I

OBJECTIVES:

• Determine the complete response rate in patients with previously untreated Burkitt's lymphoma or Burkitt's leukemia treated with rituximab and high-intensity chemotherapy with filgrastim (G-CSF) support.
• Determine the progression-free and overall survival of patients treated with this regimen.
• Determine the feasibility and toxicity of this regimen in these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to disease (leukemia vs lymphoma).

• Course 1: Patients receive cyclophosphamide IV over 5-15 minutes daily on days 1-5 and oral prednisone on days 1-7. Allopurinol PO will be given on days 1-14.
• Courses 2, 4, and 6: Patients receive ifosfamide IV over 1 hour daily on days 1-5; vincristine IV over 10 minutes and methotrexate IV over 24 hours on day 1; leucovorin calcium IV over 15 minutes every 6 hours on day 2; cytarabine IV over 2 hours on days 4 and 5 and etoposide IV over 1 hour daily on days 4 and 5; oral dexamethasone daily on days 1-5; and methotrexate and cytarabine intrathecally (IT) on day 1. During course 2, patients receive rituximab IV over 1-4 hours on days 8, 10, and 12. During courses 4 and 6, patients receive rituximab IV over 1 hour on day 8. Patients also receive filgrastim (G-CSF) subcutaneously (SC) beginning on day 7 and continuing until blood counts recover.
• Courses 3, 5, and 7: Patients receive cyclophosphamide IV over 5-15 minutes daily on days 1-5; vincristine IV over 10 minutes and methotrexate IV over 24 hours on day 1; leucovorin calcium IV every 6 hours on day 2; doxorubicin IV daily on days 4 and 5; oral dexamethasone daily on days 1-5; methotrexate and cytarabine IT on day 1; and rituximab IV over 1 hour on day 8. Patients also receive G-CSF as in courses 2, 4, and 6. After course 3, treatment continues in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually for 5 years.

PROJECTED ACCRUAL: A total of 100 patients (50 per stratum) will be accrued for this study within 3 years.