Irradiated Donor Lymphocytes and Rituximab in Treating Patients With Relapsed or Refractory Lymphoproliferative Disease

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