Chemotherapy Based on Positron Emission Tomography Scan in Treating Patients With Stage I or Stage II Hodgkin Lymphoma
Condition: Lymphoma
MeSH terms: Lymphoma; Hodgkin Disease
Intervention: Bleomycin Sulfate; Doxorubicin Hydrochloride; Procarbazine Hydrochloride; Vinblastine Sulfate; Dacarbazine; Cyclophosphamide; Etoposide phosphate; prednisone; Radiation Therapy; Fludeoxyglucose F-18; computed tomography; Positron Emission Tomography
Intervention description: Given IV; Given IV; Given PO; Given IV; Given IV; Given IV; Given IV; Given PO; Undergo radiation therapy; Undergo FDG PET/CT; Undergo FDG PET/CT; Undergo FDG PET/CT
Intervention MeSH terms: Prednisone; Cyclophosphamide; Dacarbazine; Doxorubicin; Liposomal doxorubicin; Etoposide; Bleomycin; Vinblastine; Etoposide phosphate; Procarbazine; Fluorodeoxyglucose F18
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 164.0
Sex: All
Minimum age: 18 Years
Maximum age: 60 Years
Healthy volunteers: No
Keywords: stage I adult Hodgkin lymphoma; stage II adult Hodgkin lymphoma

Summary:

      This phase II trial studies how well chemotherapy based on positron emission tomography (PET)
      scan works in treating patients with stage I or stage II Hodgkin lymphoma. Drugs used in
      chemotherapy work in different ways to stop the growth of cancer cells, either by killing the
      cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy)
      may kill more cancer cells. Radiation therapy uses high energy x-rays to kill cancer cells.
      Giving combination chemotherapy together with radiation therapy may kill more cancer cells
      and allow doctors to save the part of the body where the cancer started. Comparing results of
      diagnostic procedures, such as PET scan, done before, during, and after chemotherapy may help
      doctors predict a patient's response to treatment and help plan the best treatment.
    

Eligibility criteria:

        DISEASE CHARACTERISTICS:

          -  Histologically confirmed* Hodgkin lymphoma

               -  Clinical stage IA, IB, IIA, or IIB disease according to the modified Ann Arbor
                  Staging Classification system

               -  Subclassified according to the WHO modification of the Rye Classification

               -  "E" extension allowed provided all other criteria have been met NOTE: *Pathology
                  materials must be submitted within 60 days of study registration. Core-needle
                  biopsies are acceptable provided they contain adequate tissue for primary
                  diagnosis and immunophenotyping. Fine-needle aspirates not allowed. If multiple
                  specimens are available, submit the most recent.

          -  No nodular lymphocyte-predominant Hodgkin lymphoma

          -  No mediastinal mass > 0.33 maximum intrathoracic diameter by standing postero-anterior
             chest x-ray or peripheral or retroperitoneal adenopathy > 10 cm in its largest
             diameter

          -  Measurable disease by physical examination or imaging studies

               -  Any tumor mass measurable in two dimensions and > 1 cm (or 1.5 cm if 0.5 cm
                  slices are used, as in spiral CT scans) allowed

               -  Lesions that are considered intrinsically non-measurable include:

                    -  Bone lesions

                    -  Leptomeningeal disease

                    -  Ascites

                    -  Pleural/pericardial effusion

                    -  Lymphangitis cutis/pulmonis

                    -  Abdominal masses that are not confirmed and followed by imaging techniques

                    -  Cystic lesions

                    -  Lesions that are situated in a previously irradiated area

        PATIENT CHARACTERISTICS:

          -  Performance status 0-2

          -  ANC ≥ 1,000/μL

          -  Platelet count ≥ 100,000/μL

          -  Serum creatinine ≤ 2 mg/dL

          -  Bilirubin ≤ 2 mg/dL

          -  AST ≤ 2 times upper limit of normal

          -  LVEF normal by ECHO or MUGA

          -  DLCO ≥ 60% with no symptomatic pulmonary disease

          -  Not pregnant or nursing

          -  Negative pregnancy test

          -  Fertile patients must use effective contraception

          -  Patients with known HIV allowed provided they have CD4 counts ≥ 350/mcL

               -  Patients must not have multi-drug resistant HIV infections (i.e., concurrent
                  AIDS-defining conditions)

               -  An HIV test is required for patients with a history of IV drug abuse or any
                  behavior associated with an increased risk of HIVinfection

          -  No "currently active" second malignancy other than nonmelanoma skin cancers

               -  Patients are not considered to have a "currently active" malignancy provided they
                  have completed therapy and are considered by their physician to be at < 30% risk
                  of relapse

        PRIOR CONCURRENT THERAPY:

          -  See Disease Characteristics

          -  No prior chemotherapy or radiotherapy for Hodgkin lymphoma

               -  1 course of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) allowed
                  and will be considered the first course