Paclitaxel and Estramustine in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma
Paclitaxel and Estramustine in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
 so they stop growing or die. Combining more than one drug may kill more cancer cells.

 PURPOSE: Phase II trial to study the effectiveness of combining paclitaxel and estramustine
 in treating patients who have relapsed or refractory non-Hodgkin's lymphoma.
OBJECTIVES: I. Determine the response rate, time to treatment failure, and overall survival
 of patients with relapsed or refractory non-Hodgkin's lymphoma treated with paclitaxel and
 estramustine. II. Determine the toxicity of this regimen in this patient population.

 OUTLINE: Patients receive oral estramustine 2-3 times daily on days 1-3 and paclitaxel IV
 over 1 hour on day 2 on weeks 1-6. Treatment repeats every 8 weeks for at least 1 course in
 the absence of disease progression or unacceptable toxicity. Patients achieving a complete or
 partial response continue therapy for at least 3 courses or for 1 course after achieving
 maximum response. Patients are followed every 3 months.

 PROJECTED ACCRUAL: A total of 18-35 patients will be accrued for this study.
DISEASE CHARACTERISTICS: Histologically confirmed relapsed or refractory intermediate,
 high-grade, or transformed non-Hodgkin's lymphoma Received 1-3 prior treatment regimens
 (cytoreductive chemotherapy followed by high-dose therapy with stem cell support considered
 1 regimen) Measurable disease A new classification scheme for adult non-Hodgkin's lymphoma
 has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will
 replace the terminology of "low", "intermediate", or "high" grade lymphoma. However, this
 protocol uses the former terminology.

 PATIENT CHARACTERISTICS: Age: Over 18 Performance status: ECOG 0-2 Life expectancy: At
 least 12 weeks Hematopoietic: Granulocyte count greater than 1,500/mm3* Platelet count
 greater than 75,000/mm3* * Unless due to lymphomatous marrow involvement Hepatic: Bilirubin
 less than 1.5 mg/dL* SGOT/SGPT less than 2 times normal* * Unless due to lymphomatous
 involvement Renal: Creatinine less than 2.0 mg/dL* OR Creatinine clearance greater than 50
 mL/min* * Unless due to lymphomatous involvement Cardiovascular: No active uncontrolled
 angina pectoris No New York Heart Association class II-IV heart disease No myocardial
 infarction within the past 6 months No history of recurrent deep venous thrombosis not
 associated with catheter placement Other: No other prior malignancy within the past 5 years
 except curatively treated cervical cancer or basal cell or squamous cell skin cancer No
 serious concurrent medical illness that would preclude study No active infection

 PRIOR CONCURRENT THERAPY: Biologic therapy: See Disease Characteristics Chemotherapy: See
 Disease Characteristics At least 4 weeks since prior chemotherapy and recovered No prior
 paclitaxel, docetaxel, or estramustine Endocrine therapy: Not specified Radiotherapy: At
 least 4 weeks since prior radiotherapy and recovered Surgery: Not specified