rituximab plus interleukin-2 in treating patients with hematologic cancer

Conditions: B-cell Adult Acute Lymphoblastic Leukemia; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncontiguous Stage II Marginal Zone Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; 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 Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Splenic Marginal Zone Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma

Summary: monoclonal antibodies such as rituximab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. interleukin-2 may stimulate a person's white blood cells to kill cancer cells. combining rituximab with interleukin-2 may kill more cancer cells. phase i trial to study the effectiveness of rituximab plus interleukin-2 in treating patients who have hematologic cancer.

objectives: determine the dose-limiting toxicity of rituximab followed by low-dose and intermediate-dose pulse interleukin-2 (il-2) in patients with cd20-positive b-cell lymphoid malignancy. determine the maximum tolerated dose of intermediate-dose pulse il-2 in this patient population. determine the pharmacokinetics of this regimen in these patients. outline: this is a dose-escalation study of intermediate-dose pulse aldesleukin. patients receive rituximab iv on days 1, 8, 15, and 22. patients then receive low-dose aldesleukin subcutaneously (sc) on days 29-39, 43-53, 57-67, and 71-81, and intermediate-dose aldesleukin sc on days 40-42, 54-56, 68-70, and 82-84. cohorts of 3-6 patients receive escalating doses of intermediate-dose pulse aldesleukin until the maximum tolerated dose (mtd) is reached. the mtd is defined as the dose preceding that at which at least 2 of 6 patients experience dose-limiting toxicity. patients are followed every 3 months for 1 year. projected accrual: a total of 3-30 patients will be accrued for this study within 1 year.

Eligibility criteria:
inclusion criteria: * histologically or immunophenotypically proven cd20-positive b-cell lymphoproliferative disorder * recurrent or progressive low-grade b-cell lymphoma with at least one prior chemotherapy regimen (may have included monoclonal antibody) * relapsed intermediate-grade or high-grade b-cell lymphoma or b-lineage acute lymphoblastic leukemia and patient not a candidate for, refused, or failed prior hematopoietic stem cell transplantation * no chronic lymphocytic leukemia or lymphoma with more than 5,000/mm3circulating lymphoma cells * measurable or evaluable disease * must have failed standard curative therapy * no cns or leptomeningeal metastasis * performance status - karnofsky 70-100% * performance status - ecog 0-1 * at least 4 months * absolute neutrophil count at least 1,000/mm\^3 * hemoglobin at least 10 g/dl (transfusion allowed) * platelet count at least 50,000/mm\^3 * ast no greater than upper limit of normal (uln) * bilirubin no greater than 1.5 times uln * hepatitis b surface antigen negative * creatinine no greater than uln * no prior unstable coronary artery disease * no new york heart association class iii or iv congestive heart failure * dlco and fev1 at least 50% of predicted * hiv negative * no other concurrent malignancy except nonmelanoma skin cancer or carcinoma in situ of the cervix * no infection requiring iv antibiotic therapy within the past 4 weeks * no other major illness that would preclude study * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception * see disease characteristics * prior antibody therapy allowed * prior interleukin-2 or interferon alfa allowed * see disease characteristics * at least 4 weeks since prior chemotherapy * at least 4 weeks since prior systemic corticosteroids * at least 4 weeks since prior radiotherapy * at least 4 weeks since prior surgery