Allogeneic Stem Cell Transplantation for Mantle Cell Lymphoma

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed mantle cell lymphoma of any stage with at least 1 of the
following:

- Immunophenotype with 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

- Bone marrow biopsy required

- No needle or core biopsy as sole means of diagnosis

- First remission allowed if at least 1 of the following poor prognostic
characteristics present:

- International Prognostic Index (IPI) score higher than 1 defined by the
following risk factors:

- Performance status higher than 1

- Elevated LDH

- Presence of more than 1 extranodal site

- Stage III or IV disease

- Blastic variant of mantle cell lymphoma*

- Complex karyotypes (i.e., cytogenetic abnormalities different from or in
addition to t(11;14)*

- Proliferative index more than 10%*

- Presence of p53 mutations NOTE: *Regardless of IPI score

- Failure of initial therapy with anthracycline-containing regimen allowed

- Failure to achieve clinical complete remission after initial therapy OR

- Recurrent disease after initial therapy

- HLA matched (6/6) sibling donor by serologic typing (A, B, or DR)

- Any age

- No syngeneic (identical twin) donor

- No active CNS lymphoma

PATIENT CHARACTERISTICS:

Age:

- Under 60

Performance status:

- Not specified

Life expectancy:

- Not specified

Hematopoietic:

- Not specified

Hepatic:

- Bilirubin less than 2 mg/dL

- AST and ALT no greater than 3 times upper limit of normal

Renal:

- Creatinine less than 2 mg/dL

Pulmonary:

- DLCO at least 40%

- No symptomatic pulmonary disease

Other:

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- HIV negative

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- No prior bone marrow transplantation

Chemotherapy:

- See Disease Characteristics

- No more than 2 prior chemotherapy regimens

- No other concurrent chemotherapy

Endocrine therapy:

- No concurrent hormonal therapy

Radiotherapy:

- No concurrent radiotherapy to bulky sites

Surgery:

- See Disease Characteristics