Fludarabine and Cyclophosphamide Followed by Peripheral Stem Cell Transplant in Treating Patients With Leukemia or Lymphoma
Leukemia, Lymphoma
About this trial
This is an interventional treatment trial for Leukemia focused on measuring refractory chronic lymphocytic leukemia, stage I grade 1 follicular lymphoma, stage I grade 2 follicular lymphoma, stage I adult diffuse small cleaved cell lymphoma, stage III grade 1 follicular lymphoma, stage III grade 2 follicular lymphoma, stage III adult diffuse small cleaved cell lymphoma, stage IV grade 1 follicular lymphoma, stage IV grade 2 follicular lymphoma, stage IV adult diffuse small cleaved cell lymphoma, recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent adult diffuse small cleaved cell lymphoma, prolymphocytic leukemia, stage I mantle cell lymphoma, contiguous stage II grade 1 follicular lymphoma, contiguous stage II grade 2 follicular lymphoma, contiguous stage II adult diffuse small cleaved cell lymphoma, contiguous stage II mantle cell lymphoma, noncontiguous stage II grade 1 follicular lymphoma, noncontiguous stage II grade 2 follicular lymphoma, noncontiguous stage II adult diffuse small cleaved cell lymphoma, noncontiguous stage II mantle cell lymphoma, stage III mantle cell lymphoma, stage IV mantle cell lymphoma, recurrent mantle cell lymphoma, contiguous stage II small lymphocytic lymphoma, contiguous stage II marginal zone lymphoma, noncontiguous stage II small lymphocytic lymphoma, noncontiguous stage II marginal zone lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, splenic marginal zone lymphoma, recurrent marginal zone lymphoma, recurrent small lymphocytic lymphoma, stage I marginal zone lymphoma, stage I small lymphocytic lymphoma, stage III small lymphocytic lymphoma, stage III marginal zone lymphoma, stage IV small lymphocytic lymphoma, stage IV marginal zone lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS: One of the following histologically confirmed diagnoses: Chronic lymphocytic leukemia Absolute lymphocytosis greater than 5,000/mm^3 Morphologically mature lymphocytes with less than 55% prolymphocytes Lymphocyte phenotypic expression of CD19 and CD5 Failed at least 1 prior regimen Progressive lymphocytosis with more than 50% increase in peripheral lymphocytosis or a progressive lymph node or spleen enlargement (at least 25% enlargement or the appearance of new lymph nodes) that persists for at least 4 weeks despite concurrent or prior drug treatment OR At least 1 of the following high-risk factors and not in first complete remission = 17p deletion = 11q deletion Unmutated VH gene status p53 mutations Prolymphocytic leukemia (PLL) Absolute lymphocytosis greater than 5,000/mm^3 Morphologically mature lymphocytes with more than 55% prolymphocytes Low-grade non-Hodgkin's lymphoma Small lymphocytic lymphoma Follicular center lymphoma (grade I or II) Diffuse (predominately small cell type) Marginal zone, B-cell lymphoma No transformed lymphoma Failure of at least 1 prior regimen OR At least 3 of the following risk factors: Over 60 years of age Performance status greater than 1 LDH greater than normal More than 1 site of extranodal disease Disease stage III or IV Mantle cell lymphoma Any stage Ineligible for protocol CALGB-59908 At least 1 prior treatment regimen At least 1 of the following: Immunophenotypic expression of CD5 and CD19 and absence of CD23 Cytogenetic analysis with presence of t(11;14) Overexpression of cyclin D1 Rearrangement of BCL1 gene Responsive or stable disease to most recent prior therapy Prior therapy for PLL not required Must have HLA identical sibling (6/6) donor by serologic typing (A, B, DR) No syngeneic donors No age restriction NOTE: 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 former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology. PATIENT CHARACTERISTICS: Age: Under 70 Performance status: Not specified Life expectancy: Not specified Hematopoietic: Granulocyte count at least 500/mm^3* Platelet count at least 50,000/mm^3* NOTE: *Unless attributable to disease Hepatic: Bilirubin no greater than 3 times upper limit of normal (ULN)* AST no greater than 3 times ULN* NOTE: *Unless attributable to disease Renal: Creatinine clearance at least 40 mL/min, unless attributable to disease Cardiovascular: LVEF at least 30% by MUGA Pulmonary: DLCO greater than 40% No symptomatic pulmonary disease Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception HIV negative No uncontrolled diabetes mellitus No active serious infection No known hypersensitivity to E. coli-derived products PRIOR CONCURRENT THERAPY: Biologic therapy: No prior autologous transplantation Chemotherapy: At least 4 weeks since prior chemotherapy Endocrine therapy: Not specified Radiotherapy: At least 4 weeks since prior radiotherapy Surgery: At least 4 weeks since prior surgery
Sites / Locations
- Rebecca and John Moores UCSD Cancer Center
- Veterans Affairs Medical Center - San Diego
- UCSF Comprehensive Cancer Center
- Beebe Medical Center
- CCOP - Christiana Care Health Services
- St. Francis Hospital
- Holden Comprehensive Cancer Center at University of Iowa
- Union Hospital Cancer Center at Union Hospital
- UMASS Memorial Cancer Center - University Campus
- Cancer Institute of New Jersey at the Cooper University Hospital - Voorhees
- Roswell Park Cancer Institute
- Elmhurst Hospital Center
- Queens Cancer Center of Queens Hospital
- Mount Sinai Medical Center
- Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
- Wake Forest University Comprehensive Cancer Center
- Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University
- Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital
- Massey Cancer Center at Virginia Commonwealth University
Arms of the Study
Arm 1
Experimental
Allogeneic Stem Cell Tx
minimal ablation and cellular immune therapy with allogeneic donor stem cell therapy