Rituximab and Combination Chemotherapy in Treating Patients With Newly Diagnosed, HIV-Associated Burkitt's Lymphoma

DISEASE CHARACTERISTICS:

• Histologically confirmed Burkitt's lymphoma (BL) or new WHO 2009 criteria B-cell lymphoma unclassified (with features intermediated between difuse large B-cell lymphoma and BL)

  • Any stage disease
  • Newly diagnosed disease

• Meets 1 of the following criteria for disease risk:

  • Low-risk disease, defined by 1 of the following:

    • Stage I with a single focus of disease < 10 cm AND normal lactate dehydrogenase (LDH) level
    • Totally resected intra-abdominal disease only AND normal LDH post surgery
  • High-risk disease, defined as not meeting criteria for low-risk disease
• Measurable or nonmeasurable disease
• HIV-positive confirmed by enzyme-linked immunosorbent assay and Western blot OR by measurable HIV viral load
• No visceral Kaposi's sarcoma

PATIENT CHARACTERISTICS:

• Karnofsky performance status 40-100%
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• LVEF ≥ 50% by MUGA or echocardiogram
• Creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min
• Absolute neutrophil count ≥ 1,000/mm³
• Platelet count ≥ 50,000/mm³ (unless related to lymphoma)*
• Direct bilirubin ≤ 2.0 mg/dL OR total bilirubin ≤ 3.5 mg/dL AND direct bilirubin normal (if elevated bilirubin secondary to antiretroviral therapy)
• AST and ALT ≤ 3 times upper limit of normal
• No other malignancy within the past 5 years except curatively treated cutaneous basal cell or squamous cell carcinoma, carcinoma in situ of the cervix, or cutaneous Kaposi's sarcoma

• No other medical illness unrelated to non-Hodgkin's lymphoma, including any of the following:

  • Uncontrolled infection (including opportunistic infection)
  • Chronic renal insufficiency
  • Myocardial infarction within the past 6 months
  • Unstable angina
  • Cardiac arrhythmias other than chronic atrial fibrillation
• Patients with active hepatitis B infection are eligible provided they receive concurrent dual antiviral therapy NOTE: *Patients with bone marrow involvement are eligible irrespective of blood count

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics

• No prior therapy for this disease except for 1 of the following :

  • Seven consecutive days of steroids alone or in combination with a non-CHOP regimen necessary for patient stabilization (e.g., cyclophosphamide and steroids steroids for normalization of disease-related hyperbilirubinemia)
  • One course of CHOP or fractionated CHOP (e.g. CODOX) with or without rituximab
• No epoetin alfa or filgrastim (G-CSF) within 24 hours of study chemotherapy
• No concurrent zidovudine