Phase II Trial of Cisplatin Plus Etoposide Plus Gemcitabine Plus Solumedrol (PEGS) in Peripheral T-Cell Non-Hodgkin's Lymphoma

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Diagnosis of peripheral T-cell non-Hodgkin's lymphoma

- Newly diagnosed, relapsed or progressing disease after 1 prior treatment with a
non-platinum based chemotherapy (e.g., CHOP)

- Bulky stage II or stage III or IV disease

- The following histologies are not eligible:

- T-cell prolymphocytic leukemia

- T-cell large granular lymphocytic leukemia

- Any NK-cell leukemia

- Adult T-cell leukemia/lymphoma

- Mycosis fungoides/Sézary syndrome

- Lymphomatoid papulosis

- Nasal-type extranodal NK/T-cell lymphoma

- Enteropathy-type T-cell lymphoma

- Hepatosplenic T-cell lymphoma

- Subcutaneous panniculitis-like T-cell lymphoma

- Angioimmunoblastic T-cell lymphoma

- Primary cutaneous anaplastic large cell lymphoma (ALCL)

- ALCL with CD30, ALK, and EMA expression

- ALCL morphology that fails to express ALK or EMA allowed provided T-cell
lineage is confirmed by immunotyping or genetic testing

- Bidimensionally measurable disease

- Adequate samples (e.g., core biopsies, especially multiple core biopsies) from the
original diagnostic specimen available

- Needle aspiration or cytology is not considered adequate samples

- No clinical evidence of Central nervous system (CNS) involvement by lymphoma

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- Zubrod 0-2

Life expectancy

- Not specified

Hematopoietic

- Absolute neutrophil count ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

Hepatic

- Bilirubin ≤ 2 times upper limit of normal

Renal

- Creatinine clearance ≥ 30 mL/min

Cardiovascular

- No history of congestive heart failure

- No history of myocardial infarction

- No history of unstable angina

- No history of asymptomatic arrhythmias

- Ejection fraction normal by multigated acquisition (MUGA) scan (for patients with
questionable cardiac history)

- No other history of impaired cardiac status

Other

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No known HIV positivity

- Mild clinical hearing loss allowed provided patient is willing to accept the
potential for worsening of hearing loss

- No other malignancy within the past 5 years except adequately treated basal cell or
squamous cell skin cancer or carcinoma in situ of the cervix

- Must have had a chest x-ray or CT scan of the chest and a CT scan of the abdomen and
pelvis within the past 28 days

PRIOR CONCURRENT THERAPY:

Biologic therapy

- At least 3 weeks since prior biologic therapy

- No concurrent routine use of bone marrow colony-stimulating factors

Chemotherapy

- No other concurrent chemotherapy

Endocrine therapy

- Not specified

Radiotherapy

- No prior radiotherapy for this cancer

- No concurrent radiotherapy

Surgery

- Not specified

Other

- No prior cytotoxic therapy for this cancer

- Concurrent enrollment in SWOG-8819 or SWOG-8947 allowed