Combination Chemotherapy and Rituximab in Treating Patients With Diffuse Large B-Cell Non-Hodgkin Lymphoma

DISEASE CHARACTERISTICS:

* Histologically confirmed diffuse large B-cell non-Hodgkin lymphoma

  * International Prognostic Index (IPI) score high-intermediate (score = 3) OR high (score = 4 or 5), defined as:

    * Stage III or IV disease
    * Raised lactic dehydrogenase and poor performance status (WHO performance status 2-4)
  * All morphological variants included
  * B-cell nature of the proliferation must be verified by a positive anti-CD20 antibody (i.e., CD20-positive disease)
* No T-cell lymphoma
* No history of treated or non-treated indolent lymphoma

  * Patients newly diagnosed who have large B-cell lymphoma with some small cell infiltration in the bone marrow or lymph node may be allowed

PATIENT CHARACTERISTICS:

* See Disease Characteristics
* Life expectancy \> 3 months
* ANC \> 1,500/mm\^3\*
* Platelet count \> 100,000/mm\^3\*
* Serum creatinine \< 150 μmol/L\*
* Serum bilirubin \< 35 μmol/L\*
* AST and/or ALT \< 2.5 times upper limit of normal\* NOTE: \*Unless attributed to bone marrow infiltration by lymphoma.
* Fertile patients must use effective contraception
* Normal MUGA or echocardiogram without areas of abnormal contractility
* LVEF ≥ 50% and only tested if patient meets 1 of the following criteria:

  * History of diabetes
  * Prior cardiac disease, hypertension, or abnormal resting ECG
* No history of heart failure or uncontrolled angina pectoris
* No cardiac contraindication to doxorubicin hydrochloride (e.g., abnormal contractility on echocardiography or MUGA)
* No neurological contraindication to vincristine sulfate (e.g., pre-existing diabetic neuropathy)
* No concurrent uncontrolled medical condition
* No other serious active disease
* No general status that, according to the investigator, does not allow the administration of 2 courses of CODOX-M/IVAC
* No active malignant disease within the past 10 years except curatively treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the uterine cervix
* No positive serology for HIV or hepatitis B or C
* No medical or psychiatric conditions that compromise the patient's ability to give informed consent

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* No prior chemotherapy, radiotherapy, or other investigational drug for diffuse large B-cell non-Hodgkin lymphoma