To compare the efficacy of early intensification vs a conventional dose chemotherapy regimen for patients with intermediate grade or immunoblastic lymphoma and poor prognosis features.

Ages Eligible for Study:  15 Years   -   59 Years,  Genders Eligible for Study:  Both

Criteria

Inclusion:

• Previously untreated patients with intermediate grade lymphoma or immunoblastic lymphoma with a tumor score >=3 (or peripheral T-cell lymphoma) .
• Age 15-59.
• Divergent histologies including marrow involvement is allowed.
• CNS involvement is allowed.

Exclusion:

• Those who are unable or unlikely to be able to adhere to treatment plans or to return to Houston for follow-up visits because of geographical, economic, emotional, or social considerations.
• Hepatic dysfunction, defined as a bilirubin of 2 mg%, unless the alteration is due to lymphoma. -Serum creatinine level >1.5 mg%, unless the alteration is due to lymphoma.
• HIV infection. -Antecedent malignancy, whose prognosis is poor (<90% probability of surviving for 5 yrs.)
• Those who will not accept transfusions of blood products or supportive care measures such as antibiotics
• Those with history of chronic obstructive or restrictive lung disease will not be candidates for this study. In case of doubt and for smokers, a pulmonary consult will be requested.
• Those with symptomatic heart disease ( congestive heart failure, angina, history of MI, arrhythmias) will not be eligible for this study unless cleared by the PI after cardiology consult.