Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed CD20-positive diffuse large B-cell non-Hodgkin lymphoma
(DLBCL) according to the current WHO classification, including all morphological
variants

- Newly diagnosed disease

- Bulky stage IA-IV disease

- No non-bulky stage IA disease

- Measurable disease

- Not eligible for CHOP chemotherapy due to impaired cardiac function

- Cardiac status that does not allow the administration of 8 courses of R-CHOP
chemotherapy, as defined by 1 of the following criteria:

- Ejection fraction less than 50% as assessed by either ECHO or MUGA scan

- NYHA class III-IV

- No high-grade transformation of low-grade lymphoma

- No symptomatic central nervous system or meningeal involvement by the lymphoma

- No AIDS-related lymphoma

PATIENT CHARACTERISTICS:

- ECOG performance status 0-3

- Life expectancy > 3 months

- Platelet count > 100 x 10^9/L

- WBC > 3 x 10^9/L

- Neutrophils > 1.5 x 10^9/L (unless elevated level attributed to bone marrow
infiltration by lymphoma)

- Serum bilirubin < 50 μmol/L

- Transaminases < 2.5 times upper limit of normal (unless elevated level attributed to
lymphoma)

- Glomerular filtration rate > 30 mL/min

- Not pregnant or nursing

- Fertile patients must use effective contraception

- No other concurrent uncontrolled medical condition

- No active malignant disease, other than non-melanotic skin cancer or carcinoma in
situ of the uterine cervix, within the past 10 years

- No positive serology for HIV

- No medical or psychiatric conditions that compromise the patient's ability to give
informed consent

PRIOR CONCURRENT THERAPY:

- No prior chemotherapy, radiotherapy, or other investigational drug for this
indication