Combination Chemotherapy Followed by Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan in Treating Patients With Relapsed or Refractory AIDS-Related Non-Hodgkin's Lymphoma
AIDS-related Lymphoma, Adult Non-Hodgkin's Lymphoma, Anaplastic Large Cell Lymphoma
About this trial
This is an interventional treatment trial for AIDS-related Lymphoma focused on measuring AIDS-related diffuse large cell lymphoma, AIDS-related peripheral/systemic lymphoma, AIDS-related small noncleaved cell lymphoma, AIDS-related diffuse mixed cell lymphoma, AIDS-related immunoblastic large cell lymphoma, contiguous stage II grade 2 follicular lymphoma, contiguous stage II grade 3 follicular lymphoma, noncontiguous stage II grade 2 follicular lymphoma, noncontiguous stage II grade 3 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, stage I grade 2 follicular lymphoma, stage I grade 3 follicular lymphoma, stage III grade 2 follicular lymphoma, stage III grade 3 follicular lymphoma, stage IV grade 2 follicular lymphoma, stage IV grade 3 follicular lymphoma, contiguous stage II adult Burkitt's lymphoma, noncontiguous stage II adult Burkitt's lymphoma, recurrent adult Burkitt's lymphoma, stage I adult Burkitt's lymphoma, stage III adult Burkitt's lymphoma, stage IV adult Burkitt's lymphoma, anaplastic large cell lymphoma, contiguous stage II adult diffuse large cell lymphoma, noncontiguous stage II adult diffuse large cell lymphoma, recurrent adult diffuse large cell lymphoma, stage I adult diffuse large cell lymphoma, stage III adult diffuse large cell lymphoma, stage IV adult diffuse large cell lymphoma, contiguous stage II adult diffuse mixed cell lymphoma, noncontiguous stage II adult diffuse mixed cell lymphoma, recurrent adult diffuse mixed cell lymphoma, stage I adult diffuse mixed cell lymphoma, stage III adult diffuse mixed cell lymphoma, stage IV adult diffuse mixed cell lymphoma, contiguous stage II adult immunoblastic large cell lymphoma, noncontiguous stage II adult immunoblastic large cell lymphoma, recurrent adult immunoblastic large cell lymphoma, stage I adult immunoblastic large cell lymphoma, stage III adult immunoblastic large cell lymphoma, stage IV adult immunoblastic large cell lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically documented B-cell non-Hodgkin's lymphoma, including any of the following histologic types: Follicular large B-cell lymphoma (follicular, grade 3) Follicular mixed cell lymphoma (follicular, grade 2) Diffuse mixed cell lymphoma Diffuse large B-cell lymphoma Immunoblastic lymphoma Burkitt or Burkitt-like lymphoma Anaplastic large cell lymphoma Primary effusion lymphoma All stages eligible Seropositive for HIV by any approved test or positive HIV-1 RNA in plasma at anytime in the past Prior documentation of HIV seropositivity allowed Received 1 prior anthracycline-based regimen of curative intent No more than 1 prior regimen Measurable or evaluable disease Evaluable disease defined as not having bidimensional measurements (i.e., gastric or marrow involvement) but can be followed for response by other diagnostic tests, such as gallium scan, positron emission tomography (PET) imaging and/or bone marrow biopsy No primary CNS lymphoma Lymphomatous meningitis or brain metastasis eligible provided other measurable systemic lymphomatous disease is also present Less than 25% bone marrow involvement with lymphoma Concurrent effective highly active anti-retroviral therapy (HAART) required at study entry HIV viral load < 100,000 copies/mL if HAART was not used previously PATIENT CHARACTERISTICS: Karnofsky performance status 50-100% Bilirubin ≤ 2.0 mg/dL (unless elevated due to lymphomatous involvement of the liver or biliary tract OR due to other HIV medications [e.g., indinavir or atazanavir]) Creatinine < 2.0 mg/dL (< 2.6 mg/dL if due to use of tenofovir or truvada) OR creatinine clearance ≥ 60 mL/min Granulocyte count > 1,000/mm^3 (unless abnormal due to lymphomatous involvement of the bone marrow) Platelet count > 75,000/mm^3 (unless abnormal due to lymphomatous involvement of the bone marrow or HIV-related thrombocytopenia) No acute intercurrent infection that may interfere with study participation Mycobacterium avium allowed No second active tumor except nonmelanomatous skin cancer, carcinoma in situ of the cervix, or Kaposi's sarcoma not requiring systemic chemotherapy Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for ≥ 6 months after completion of study treatment No serious, ongoing nonmalignant disease or infection that would compromise study objectives No antimurine antibody (HAMA) reactivity No history of any cutaneous or mucocutaneous reaction from prior rituximab administration No history of cutaneous or mucocutaneous reactions or diseases severe enough to cause hospitalization or an inability to eat for ≥ 2 days PRIOR CONCURRENT THERAPY: See Disease Characteristics Fully recovered from all toxicities associated with prior surgery, radiotherapy, chemotherapy, or immunotherapy Prior chronic therapy with potentially myelosuppressive agents allowed provided hematologic criteria are met at study entry No radiotherapy within the past 4 weeks, unless for emergency conditions secondary to lymphoma (i.e., cord compression) No anticancer therapy within the past 3 weeks (6 weeks for nitrosourea or mitomycin C) No rituximab within 6 weeks before study radioimmunotherapy No investigational agent(s) within the past 4 weeks, unless these are antiretroviral agents available on a compassionate use basis No prior external beam radiotherapy to > 25% of active bone marrow (involved field or regional) No major surgery, other than diagnostic surgery, within the past 4 weeks No prior myeloablative therapies with autologous bone marrow transplantation, peripheral blood stem cell rescue, or failed stem cell collection No prior radioimmunotherapy No pegfilgrastim within 4 weeks before study radioimmunotherapy No other growth factors within 2 weeks before and after study radioimmunotherapy No other concurrent myelosuppressive antineoplastic agents after receipt of study radioimmunotherapy until blood counts recover No zidovudine-containing regimens (including lamivudine and trizivir) during and for ≥ 2 months after completion of study radioimmunotherapy