A Pilot Study of Irradiated HLA-Partially Matched Allogeneic Related Donor Lymphocytes in Conjunction With Rituximab for Selected Patients With CD20 + Malignancies

Inclusion 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