OBJECTIVES:
Primary
* Evaluate the efficacy of rituximab, bortezomib, doxorubicin hydrochloride, dexamethasone, and chlorambucil as first-line therapy in patients with stage II-IV mantle cell lymphoma.
Secondary
* Determine the complete response rate in these patients.
* Determine the efficacy, in terms of complete and overall response, by F18 fludeoxyglucose scan.
* Determine overall, disease-free, and event-free survival of these patients.
* Assess tolerability of this regimen in these patients.
* Evaluate the impact of factors, described in previous protocols, on response to therapy and survival.
* Assess the impact of residual disease in cerebrospinal fluid on survival.
OUTLINE: This is a multicenter study.
Patients receive rituximab IV on day 1 (days 1 and 8 of the first course only); bortezomib IV on days 1, 4, 8, and 11; doxorubicin hydrochloride IV continuously over 24 hours on days 1-4; dexamethasone IV on days 1-4; and oral chlorambucil on days 20-29. Treatment repeats every 5 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
Patients who achieve at least 50% response receive 2 additional courses of therapy.
