Yttrium Y 90 Ibritumomab Tiuxetan in Treating Patients With Waldenstrom's Macroglobulinemia

DISEASE CHARACTERISTICS:

• Diagnosis of Waldenstrom's macroglobulinemia confirmed by IgM gammopathy and bone marrow biopsy

  • Presence of lymphoplasmacytic cells
  • CD20+ plasma cell dyscrasia on the majority of malignant cells
  • Bone marrow involvement of 20-50% by core needle biopsy of at least 1.5 cm in length

• Clinical indication for initiation of treatment, including 1 or more of the following characteristics:

  • Symptoms associated with the disease (e.g., fatigue, asthenia, or painful adenopathy)
  • Anemia
  • IgM greater than 3 g/L
  • Progression as indicated by a rate of IgM rise of more than 0.5 g over 6 months
• No myelodysplastic syndromes or profound hypocellularity of the bone marrow

PATIENT CHARACTERISTICS:

Age

• Over 18

Performance status

• WHO 0-2

Life expectancy

• More than 3 months

Hematopoietic

• Absolute neutrophil count greater than 1,500/mm^3
• Total B-lymphocyte count less than 5,000/mm^3
• Platelet count greater than 100,000/mm^3
• No hyperviscosity syndrome

Hepatic

• Bilirubin no greater than 1.5 mg/dL

Renal

• Not specified

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 1 year after study completion
• No uncontrolled CNS disease
• No serious nonmalignant disease that would preclude study participation
• No other concurrent active malignancy except controlled skin cancer or prostate cancer

PRIOR CONCURRENT THERAPY:

Biologic therapy

• More than 2 weeks since prior filgrastim (G-CSF) or sargramostim (GM-CSF)
• More than 4 months since prior rituximab
• No prior radioimmunotherapy

Chemotherapy

• No prior high-dose chemotherapy (unless patient has had prior back-up stem cell collections)
• More than 6 weeks since prior chemotherapy

Endocrine therapy

• More than 4 weeks since prior corticosteroids

Radiotherapy

• No prior radiotherapy

Surgery

• Not specified