Rituximab-HyperCVAD (R-HCVAD) Alternating With Rituximab-Methotrexate-Cytarabine- (R-MC) in Newly Diagnosed Patients With Diffuse Large B-Cell Lymphoma With MYC-Rearrangement.

Inclusion Criteria

• •1. Diffuse large B-cell lymphoma or intermediate ("Burkitt-like") lymphoma, newly diagnosed from an excisional biopsy or from a large core biopsy with sufficient diagnostic material to perform genetic testing for MYC-R.
• •2. Positivity for MYC-R by Fluorescent in-situ Hybridization (FISH) or by classical cytogenetics.
• •3. No prior lymphoma treatment, with one exception: One cycle of R-CHOP regimen is permitted (consisting of one single dose each of Rituximab, of cyclophosphamide, of doxorubicine, and of vincristine, as well as up to 5 doses of Prednisone when part of chemotherapy).
• •4. No prior radiation therapy is permitted
• •5. Age ≥ 18 years to 70 years of age
• •6. CT imaging of neck, chest, abdomen and pelvis within 28 days prior to registration. Any additional imaging used to assess extent of disease must also have been done within 28 days prior to registration
• •7. Bidimensionally measurable disease by imaging within 28 days prior to registration
• •8. Adequate bone marrow biopsy, and aspiration performed for staging within 28 days before registration, and before start of any treatment
• •9. Indication for primary treatment with systemic multiagent chemotherapy
• •10. Creatinine ≤ 2.0 mg/dL and estimated (Cockroft-Gault) creatinine clearance\> 50 ml/min within 7 days prior to registration
• •11. Cardiac ejection fraction of ≥ 50% by MUGA scan or by 2-D echocardiogram , as well as EKG without significant abnormality within 28 days prior to registration
• •12. Performance status of 0, of 1, or of 2 (ECOG scale)
• •13. Patient willing to have, and to maintain, a central venous line throughout the treatment phase (either PICC line, or double lumen tunnelled catheter, or double lumen subcutaneous venous port system)
• •14. Willing and logistically able to be followed as outpatient at least twice weekly, during the treatment phase.
• •15. Signed informed consent to accept transfusion of blood products as medically indicated
• •16. Signed informed consent to participate in this trial