RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy consisting of cyclophosphamide, etoposide, and cisplatin in treating patients with intermediate or high-grade non-Hodgkin's lymphoma who have relapsed following or are resistant to anthracycline -containing primary combination chemotherapy.

OBJECTIVES: I. Determine the efficacy of high-dose cyclophosphamide/etoposide/cisplatin in patients with intermediate- or high-grade non-Hodgkin's lymphoma who have failed primary combination chemotherapy but still respond to conventional-dose DHAP (dexamethasone/cytarabine/cisplatin) and are not candidates for bone marrow transplantation.

II. Determine the toxicity of the intensification chemotherapy regimen in this group of patients.

PROTOCOL OUTLINE: Nonrandomized study.

3-Drug Combination Chemotherapy. CVP: Cyclophosphamide, CTX, NSC-26271; Etoposide, VP-16, NSC-141540; Cisplatin, CDDP, NSC-119875.

PROJECTED ACCRUAL: If at least 1 CR is seen in the first 6 patients, an estimated maximum of 20 patients will be enrolled. If 3 or more of the first 10 patients (or 25% of the study population thereafter) die within the first 35 days of treatment from causes unrelated to tumor progression, the study will be terminated.

Ages Eligible for Study:  18 Years   -   64 Years

Criteria

PROTOCOL ENTRY CRITERIA:

--Disease Characteristics--

• Histologically confirmed intermediate- or high-grade non-Hodgkin's lymphoma of the following histologies: Follicular, predominantly large cell; Diffuse small cleaved cell; Diffuse mixed, small and large cell; Diffuse large cell; Large cell, immunoblastic; Lymphoblastic; Small noncleaved cell
• Disease has relapsed following or is resistant to primary anthracycline-containing combination chemotherapy
• Objective response to salvage DHAP chemotherapy required
• Ineligible for bone marrow transplantation

--Prior/Concurrent Therapy--

• Biologic therapy: Not specified
• Chemotherapy: Prior anthracycline-containing combination chemotherapy required; Prior salvage DHAP chemotherapy required
• Endocrine therapy: Not specified
• Radiotherapy: Not specified
• Surgery: Not specified

--Patient Characteristics--

• Age: 18 to 64
• Performance status: Zubrod 0 or 1
• Hematopoietic: ANC at least 1,500; Platelets at least 140,000; Hb at least 10 g/dl
• Hepatic: Bilirubin less than 1.5 mg/dl (26 micromoles/liter); SGOT less than 4 x normal
• Renal: Creatinine less than 1.5 mg/dl (133 micromoles/liter)
• Cardiovascular: LVEF greater than 50%; No life-threatening arrhythmia by EKG; No uncontrolled hypertension
• Pulmonary: FEV, FVC, and DLCO greater than 50% of predicted
• Other: No uncontrolled diabetes; No other uncontrolled medical condition; No history of second malignancy except: Nonmelanomatous skin cancer; Carcinoma in situ; Effective contraception required of fertile women