Irradiated Donor Lymphocytes and Rituximab in Treating Patients With Relapsed or Refractory Lymphoproliferative Disease
Leukemia, Lymphoma, Multiple Myeloma and Plasma Cell Neoplasm
About this trial
This is an interventional treatment trial for Leukemia focused on measuring extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, recurrent adult Burkitt lymphoma, recurrent adult diffuse large cell lymphoma, recurrent adult Hodgkin lymphoma, recurrent adult lymphoblastic lymphoma, recurrent adult acute lymphoblastic leukemia, refractory chronic lymphocytic leukemia, recurrent small lymphocytic lymphoma, refractory hairy cell leukemia, prolymphocytic leukemia, recurrent marginal zone lymphoma, recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, refractory multiple myeloma, recurrent mantle cell lymphoma, recurrent adult grade III lymphomatoid granulomatosis, Waldenstrom macroglobulinemia, splenic marginal zone lymphoma, stage II multiple myeloma, stage III multiple myeloma, stage IV adult Burkitt lymphoma, stage IV adult diffuse large cell lymphoma, stage IV adult Hodgkin lymphoma, stage IV adult lymphoblastic lymphoma, stage III adult Burkitt lymphoma, stage III adult diffuse large cell lymphoma, stage III adult Hodgkin lymphoma, stage III adult lymphoblastic lymphoma, stage III grade 1 follicular lymphoma, stage III grade 2 follicular lymphoma, stage III grade 3 follicular lymphoma, stage IV grade 1 follicular lymphoma, stage IV grade 2 follicular lymphoma, stage IV grade 3 follicular lymphoma, stage III mantle cell lymphoma, stage IV mantle cell lymphoma, stage III marginal zone lymphoma, stage IV marginal zone lymphoma, stage III small lymphocytic lymphoma, stage IV small lymphocytic lymphoma, stage III chronic lymphocytic leukemia, stage IV chronic lymphocytic leukemia, progressive hairy cell leukemia, initial treatment
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed lymphoproliferative disease CD20-positive disease Bidimensionally measurable disease OR abnormal cells detected in blood Resistant or refractory to standard therapies and/or unlikely to benefit from additional standard therapies* AND meets 1 of the following criteria: Disease with anticipated response rate < 20% after treatment with rituximab alone, including any of the following: Diffuse large cell lymphoma B-cell lymphoblastic lymphoma Burkitt's lymphoma Acute lymphocytic leukemia Relapsed or progressive disease after prior treatment with rituximab, including any of the following: Hodgkin's lymphoma Hairy cell leukemia Chronic lymphocytic leukemia/small lymphocytic lymphoma meeting any of the following criteria: Received prior fludarabine phosphate-containing regimens and relapsed within 1 year of treatment OR ineligible to receive such therapy due to comorbidities or allergies Received prior anti-CD52 monoclonal antibody therapy and relapsed within 1 year of treatment OR ineligible to receive such therapy (for patients without symptomatic lymphadenopathy) Has documentation of disease-associated symptoms, rapid disease progression, or other indications for treatment B-cell prolymphocytic leukemia meeting any of the following criteria: Received prior fludarabine phosphate- or alkylating agent-containing regimens and relapsed within 1 year of treatment OR ineligible to receive such therapy due to comorbidities or allergies Received prior anti-CD52 monoclonal antibody therapy OR ineligible to receive such therapy (for patients without symptomatic lymphadenopathy) Lymphoplasmacytic lymphoma, marginal zone lymphoma, mucosa-associated lymphoid tissue lymphoma, or follicular lymphoma meeting any of the following criteria: Received prior fludarabine phosphate- and/or alkylating agent-containing regimens and relapsed within 1 year of treatment OR ineligible to receive such therapy due to comorbidities or allergies Received prior anti-CD20 monoclonal antibody therapy and relapsed within 1 year of treatment OR ineligible to receive such therapy Received prior radioconjugated anti-CD20 monoclonal antibody therapy OR ineligible to receive such therapy Has documentation of disease-associated symptoms, rapid disease progression, or other indications for treatment Multiple myeloma meeting any of the following criteria: Received prior alkylating agent-, thalidomide-, corticosteroid-, or bortezomib-containing regimens and relapsed after 1 year of treatment OR ineligible to receive such therapies due to comorbidities or allergies Received prior high-dose chemotherapy followed by autologous hematopoietic stem cell rescue and relapsed after treatment OR ineligible to receive such therapy Mantle cell lymphoma meeting the following criteria: Received prior combination chemotherapy and anti-CD20 monoclonal antibody therapy and relapsed after treatment OR ineligible to receive such therapy Diffuse large B-cell lymphoma meeting any of the following criteria: Received prior combination chemotherapy and relapsed after treatment OR ineligible to receive such therapy Received prior salvage combination chemotherapy with or without high-dose chemotherapy followed by autologous hematopoietic stem cell rescue and relapsed after treatment OR not a candidate to receive such therapy Received prior radiolabeled anti-CD20 monoclonal antibody therapy for transformed large cell lymphoma OR ineligible to receive such therapy Burkitt's lymphoma meeting any of the following criteria: Received prior combination chemotherapy and relapsed after treatment OR ineligible to receive such therapy Received prior salvage combination chemotherapy with or without high-dose chemotherapy followed by autologous hematopoietic stem cell rescue and relapsed after treatment OR ineligible to receive such therapy Lymphomatoid granulomatosis meeting any of the following criteria: Received prior single-agent or combination chemotherapy and relapsed after treatment OR ineligible to receive such therapy Has documentation of disease-associated symptoms, rapid disease progression, or other indications for treatment Acute lymphocytic leukemia meeting any of the following criteria: Received prior multi-agent combination chemotherapy administered in sequential induction, consolidation, and maintenance courses and relapsed during or after treatment OR ineligible to receive such therapy Received prior chemotherapy with or without radiotherapy followed by allogeneic hematopoietic stem cell transplantation (HSCT) and relapsed after treatment OR not a candidate for such therapy Received prior treatment with chemotherapy with or without radiotherapy followed by allogeneic HSCT and relapsed after treatment (or not a candidate for such therapy) AND demonstrates persistent cytogenetic, fluorescent in situ hybridization, or molecular (reverse transcriptase-polymerase chain reaction) evidence of the bcr-abl fusion gene despite 6 weeks of treatment with imatinib mesylate NOTE: *Not eligible to receive standard available salvage regimens anticipated to result in durable remission No active CNS malignancy Not considered a candidate for allogeneic HSCT HLA-partially matched (≥ 2/6) related donor available PATIENT CHARACTERISTICS: ECOG performance status 0-1 Life expectancy > 3 months Not pregnant Negative pregnancy test Fertile women must use effective contraception Bilirubin < 1.5 times upper limit of normal (ULN) AST < 3.0 times ULN Cardiac ejection fraction > 35% Absolute neutrophil count > 1,000/mm³ (without cytokines) Platelet count > 50,000/mm³ (untransfused) No significant organ dysfunction No active uncontrolled infections No hypersensitivity reaction to rituximab that has precluded completion of a 4-week course of rituximab therapy No uncontrolled psychiatric illness or medical condition that would preclude tolerance of study treatment PRIOR CONCURRENT THERAPY: See Disease Characteristics Recovered from prior therapy for at least 7 days More than 30 days since prior cytotoxic chemotherapy At least 14 days since prior steroids At least 14 days since prior radiotherapy to non-target lesions
Sites / Locations
- Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
Arms of the Study
Arm 1
Experimental
Therapeutic allogeneic lymphocytes with rituximab