mdx-010 in treating patients with recurrent or refractory lymphoma

Conditions: Adult Grade III Lymphomatoid Granulomatosis; B-cell Chronic Lymphocytic Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

Summary: biological therapies, such as mdx-010, work in different ways to stimulate the immune system and stop cancer cells from growing. this phase i/ii trial is studying the side effects and best dose of mdx-010 and to see how well it works in treating patients with recurrent or refractory b-cell non-hodgkin's lymphoma.

primary objectives: i. to characterize the safety profile of mdx-010 (ipilimumab) monoclonal antibody and identify a tolerable immunologically active dose level in b cell lymphoma patients. ii. to evaluate the clinical response rate in b cell lymphoma patients treated with mdx-010. secondary objectives: i. to evaluate the phenotype and function of memory t cells before and after treatment with mdx-010 by: * quantitation and phenotypic characterization of peripheral blood and tumor infiltrating t-cells, including cluster of differentiation (cd)4+cd25+ regulatory t cells. * measurement of tumor-specific t cells in peripheral blood lymphocytes. * measuring proliferation of memory t cells in response to recall antigens (tetanus toxoid and keyhole limpet hemocyanin \[klh\]). ii. measurement of anti-tumor antibodies in serum pre- and post-therapy. iii. to evaluate the time to progression. iv. to evaluate the duration of response to treatment with mdx-010. outline: this is a multicenter, open-label, phase i, dose-escalation study followed by a phase ii study. patients are grouped according to prior treatment with a vaccine therapy for lymphoma (yes vs no). phase i: patients receive anti-cytotoxic t-lymphocyte-associated antigen-4 monoclonal antibody (mdx-010) iv over 90 minutes on day 1. treatment repeats every 28 days for a total of 4 courses in the absence of disease progression or unacceptable toxicity. cohorts of 6 patients from each group receive escalating doses of mdx-010 until the maximum tolerated dose (mtd) is determined. the mtd is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. phase ii: patients receive mdx-010 as in phase i at the mtd. patients are followed at 1 and 4 months and then every 6 months for up to 2 years.

Eligibility criteria:
inclusion criteria: * histologic proof of recurring or residual follicular b-cell non-hodgkin's lymphoma (grade i or ii), by revised european american lymphoma classification (real) or world health organization (who) classifications which has relapsed or persisted after 3 or fewer conventional therapies, including chemotherapy or monoclonal antibody therapy; note: all patients with previously treated b-cell lymphomas of any histology with the exception of small lymphocytic lymphoma/chronic lymphocytic leukemia (cll) are eligible * tumor measurable by computed tomography (ct) scans (at least one pathologic node measuring 2.0 x 2.0 cm, or 2 nodes measuring \> 1.5 x 1.5 cm after collection of tumor for immunologic analyses) * at least one prior treatment regimen but no more than 3 prior chemotherapy regimens; patients previously treated with monoclonal antibodies or radiotherapy to a single site will be eligible; these therapies will be considered prior treatment regimens but will not be considered as prior chemotherapy; tumor vaccines will not be counted as prior therapies, as all such agents are investigational * absolute neutrophil count (anc) \>= 1000/ul * platelets (plt) \>= 75,000/ul * total bilirubin =\< 1.5 x upper limit of normal (uln) * aspartate aminotransferase (ast) =\< 3 x upper limit or normal (uln) * creatinine =\< 1.5 x uln * hemoglobin \>= 8 g/dl * ability to provide informed consent * willingness to return to the mayo clinic rochester or the university of california, los angeles for follow up * life expectancy \>= 24 weeks * willingness to provide all biologic specimens as required by the protocol exclusion criteria: * known standard therapy for the patient's disease that is potentially curative or definitely capable of extending life expectancy * eastern cooperative oncology group (ecog) performance status (ps) 2, 3, or 4 * any uncontrolled infection, hepatitis c virus (hcv)+ (unless hcv ribonucleic acid \[rna\]-negative by polymerase chain reaction \[pcr\]) or hepatitis b surface antigen (hbsag)+, or human immunodeficiency virus (hiv) positive patients or patients with known immune deficiency states * previous mdx-010 therapy regardless of interval since last treatment * prior treatment with fludarabine or 2-chlorodeoxyadenosine =\< 12 months prior to registration * failure to fully recover from acute, reversible effects of prior chemotherapy regardless of interval since last treatment * new york heart association classification iii or iv or a history of angina pectoris requiring active treatment * clinical evidence of central nervous system involvement by lymphoma * any of the following: * pregnant women * nursing women * men or women of childbearing potential who are unwilling to employ adequate contraception (condoms, diaphragm, birth control pills, injections, intrauterine device \[iud\], or abstinence, etc.) * other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy considered investigational (utilized for a non-food and drug administration \[fda\]-approved indication and in the context of a research investigation) * diagnosis of small lymphocytic lymphoma/chronic lymphocytic leukemia (cll) * any requirement for concurrent steroid therapy, including use of inhaled steroids for asthma * history of autoimmune disease requiring systemic therapy with immunosuppressive drugs, including but not limited to rheumatoid arthritis, inflammatory bowel disease, systemic lupus erythematosus, multiple sclerosis, or psoriasis * antinuclear antibody (ana) titer or rheumatoid factor titer \> 3x institutional uln