Inclusion criteria
- Previously untreated patients with newly diagnosed peripheral T-cell lymphoma of stage I bulk (>= 7.5 cm) and stages II to IV.
- Patients with a confirmed histologic diagnosis of peripheral T-cell NHL according to the WHO classification (Appendix C):
- Peripheral T-cell lymphoma, unspecified (PTCL NOS)
- Angioimmunoblastic T-cell lymphoma
- Enteropathy-type T-cell lymphoma
- Subcutaneous panniculitis-like T-NHL
- Hepatosplenic T-cell lymphoma
- Extranodal NK/T cell lymphoma, nasal type
- Age 18-60 years at the time of randomization
- Life expectancy of 3 months or longer
- ECOG performance status 0, 1 or 2 at randomization (see appendix D). PS 3 acceptable if lymphoma-related.
- Measurable disease
- Written informed consent
Exclusion criteria
- Patients with NK/T-NHL of the following type:
- Precursor T cell lymphoblastic lymphoma/ leukemia
- All mature T cell leukemias (T-PLL, ATLL, NK cell leukemia, T-LGL, HTVL1-pos ATL)
- Alk-positive and negative anaplastic large cell lymphoma
- Blastic NK cell lymphoma
- Cutaneous T-cell lymphoma, transformed or not
- Concurrent severe and/or uncontrolled medical disease (e.g.uncontrolled diabetes, congestive heart failure, myocardial infarction within 6 months prior to the study, unstable and uncontrolled hypertension, chronic renal disease, or active uncontrolled infection), which could compromise participation in the study.
- Known hypersensitivity to murine or chimeric antibodies or proteins
- Severe cardiac dysfunction (NYHA classification II-IV) or LVEF < 45 %
- Significant renal dysfunction (serum creatinin >2 times upper limit of normal), unless related to NHL
- Significant hepatic dysfunction (total bilirubin > 2 times ULN or transaminases >= 2.5 times ULN), unless related to NHL
- Impaired pulmonary functions; in this case, the patient is to be excluded if the resultant pulmonary function test shows FEV1<50% or a diffusion capacity <50% of the reference values
- Suspected or documented central nervous system involvement by NHL
- Patients known to be HIV-positive
- Patients with active, uncontrolled infections, especially known seropositivity for HCV or HbsAg
- Prior treatment with chemotherapy, radiotherapy or immunotherapy for this lymphoma, except local radiotherapy in case of extranodal NK/T cell lymphoma, nasal type
- History of active cancer during the past 5 years, except basal carcinoma of the skin or stage 0 cervical carcinoma
- Unwillingness or inability to comply with the protocol
- Simultaneous participation in any other study protocol
- Pregnant and nursing women