Rituximab, Gemcitabine, and Vinorelbine in Treating Patients With Hodgkin Lymphoma That Has Relapsed or Not Responded to Treatment
Lymphoma
About this trial
This is an interventional treatment trial for Lymphoma focused on measuring recurrent adult Hodgkin lymphoma, adult lymphocyte depletion Hodgkin lymphoma, adult lymphocyte predominant Hodgkin lymphoma, adult mixed cellularity Hodgkin lymphoma, adult nodular sclerosis Hodgkin lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS:
Pathologically confirmed classical Hodgkin lymphoma, including 1 of the following cell types:
- Nodular sclerosis
- Mixed cellularity
- Lymphocyte-rich
- Lymphocyte-depleted
- Measurable disease using the Cheson criteria, defined as ≥ 1 unidimensionally measurable lesion ≥ 2.0 cm by conventional techniques OR ≥ 1.0 cm by spiral CT scan
- Progressive or relapsed disease after ≥ 1 prior line of combination chemotherapy
- No known CNS metastasis
PATIENT CHARACTERISTICS:
- ECOG performance status 0-1
- ANC > 1,500/mm^3
- Platelet count > 75,000/mm^3
- Total bilirubin ≤ 2 mg/dL (unless due to hemolysis)
- AST or ALT ≤ 2.5 times upper limit of normal
- Creatinine normal OR creatinine clearance ≥ 50 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No active hepatitis B infection
- No known chronic hepatitis B carrier
- No HIV positivity
No concurrent uncontrolled illness including, but not limited to, any of the following:
- Symptomatic neurological illness
- Active uncontrolled systemic infection considered opportunistic, life-threatening, or clinically significant at the time of study treatment
- Symptomatic congestive heart failure
- Unstable angina pectoris
- Cardiac arrhythmia
- Significant pulmonary disease or hypoxia
- Psychiatric illness or social situation that would limit compliance with study requirements
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- More than 14 days since prior chemotherapy, immunotherapy, biological therapy, or investigational therapy and recovered
- No prior gemcitabine hydrochloride, vinorelbine ditartrate, or rituximab
- No other concurrent investigational or commercial agents or therapies with the intent to treat the malignancy
Sites / Locations
- University of Miami Sylvester Comprehensive Cancer Center - Miami
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Group 1 (eligible for SCT)
Group 2 (ineligible for SCT)
Patients receive rituximab IV, vinorelbine ditartrate IV over 6-10 minutes, and gemcitabine hydrochloride IV over 30 minutes on day 1 and pegfilgrastim subcutaneously on day 2. Treatment repeats every 14 days for up to 3 courses in the absence of disease progression or unacceptable toxicity. Patients with complete response (CR) or partial response (PR) undergo SCT.
Patients receive rituximab, vinorelbine ditartrate, gemcitabine hydrochloride, and pegfilgrastim as in group 1. Patients with CR, PR, or stable disease after 3 courses continue to receive therapy in the absence of disease progression or unacceptable toxicity.