RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer cells. Peripheral stem cell transplantation may allow doctors to give higher doses of chemotherapy and radiation therapy and kill more cancer cells.

PURPOSE: Phase I/II trial to study the effectiveness of etoposide plus radiation therapy followed by peripheral stem cell transplantation in treating patients who have non-Hodgkin's lymphoma.

OBJECTIVES: I. Evaluate the overall and progression-free survival of patients with selected poor-prognosis non-Hodgkin's lymphomas treated with high-dose etoposide and total-body irradiation followed by rescue with peripheral blood stem cells.

II. Determine the toxicity of this regimen.

III. Evaluate the short-term and long-term engraftment characteristics of patients treated on this regimen.

PROTOCOL OUTLINE: Patients who respond on Regimen A and who have no bulk disease greater than 5 cm are treated on Regimen B.

Regimen A: Single-Agent Chemotherapy/Stem Cell Mobilization with Urothelial Protection and Growth Factor Therapy. Cyclophosphamide, CTX, NSC-26271; with Mesna, NSC-113891; and Granulocyte Colony Stimulating Factor (Amgen), G-CSF, NSC-614629.

Regimen B: Sequential Radiotherapy, Single-Agent Chemotherapy, and Stem Cell Rescue. Total-body irradiation, TBI (equipment not specified); Etoposide, VP-16, NSC-141540; and Peripheral Blood Stem Cells, PBSC.

PROJECTED ACCRUAL: 20 patients will be studied.

Ages Eligible for Study:  16 Years   -   65 Years

Criteria

PROTOCOL ENTRY CRITERIA:

--Disease Characteristics--

• Pathologically confirmed non-Hodgkin's lymphomas of the following histologic subtypes: Small lymphocytic; Follicular small cleaved cell; Follicular mixed cell; Follicular large cell (relapsed)
• Disease in first, second, or third partial remission (25% shrinkage in cross-sectional area of measurable disease) or first, second, or subsequent relapse required
• Transformed non-Hodgkin's lymphoma eligible, i.e., low-grade lymphoma subsequently transformed to intermediate- or high-grade lymphoma
• No lymphosarcoma cell leukemia

--Prior/Concurrent Therapy--

• Biologic therapy: Not specified
• Chemotherapy: Not specified
• Endocrine therapy: Not specified
• Radiotherapy: Less than 3,500 cGy prior irradiation to the mediastinum, lungs, or spinal cord
• Surgery: Not specified

--Patient Characteristics--

• Age: 16 to 65
• Performance status: Karnofsky 80-100%
• Hematopoietic: WBC at least 5,000/mm3 (polys at least 2,000/mm3); Platelet count at least 100,000/mm3
• Hepatic: Bilirubin no greater than 2.0 mg/dL; SGOT no greater than 2 times normal
• Renal: Creatinine no greater than 1.8 mg/dL
• Cardiovascular: LVEF at least 50%
• Pulmonary: FVC greater than 1.5 liters; FEV1 greater than 1.2 liters; MVV greater than 50 liters; DLCO greater than 12 mL/min; pO2 greater than 70 mm Hg on room air
• Other: No other serious psychiatric, neurologic, or medical illness