Combination Chemotherapy and Rituximab in Treating Young Patients With Recurrent or Refractory Non-Hodgkin’s Lymphoma or Acute Lymphoblastic Leukemia

Inclusion Criteria:

Histologically confirmed B-cell non-Hodgkin's lymphoma OR acute lymphoblastic leukemia

CD20+ (confirmed by flow cytometry of tumor tissue, involved marrow, or CD20 immunostaining)

The following histologies are generally CD20+ and are eligible:

Diffuse large B-cell lymphoma, mediastinal (thymic) large B-cell lymphoma, or follicular lymphoma, grade III (rare), documented by flow cytometry or appropriate immunohistochemistry, any stage
Burkitt's lymphoma or atypical Burkitt's/Burkitt-like lymphoma, any stage
B-cell acute lymphoblastic leukemia, with FABL3 morphology and/or demonstration of surface immunoglobin by flow cytometry
Atypical precursor B-cell lymphoblastic lymphoma or other unusual histologies that are CD20+
Measurable disease by clinical, radiographic, or histologic criteria
Must be in first or later recurrence or have disease that is primarily refractory to conventional therapy
No isolated CNS disease
Performance status - ECOG 0-2
At least 2 months
Absolute neutrophil count ≥ 1,000/mm^3*
Platelet count ≥ 100,000/mm^3 (transfusion independent)*
Hemoglobin ≥ 10.0 g/dL (RBC transfusion allowed)*
Bilirubin ≤ 1.5 times normal
ALT < 2.5 times normal

No chronic renal insufficiency

Renal insufficiency allowed provided it is secondary to tumor lysis syndrome
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 3 months after study treatment
HIV negative
No active uncontrolled infection
Seizure disorder allowed if well controlled with anticonvulsants
No CNS toxicity greater than grade II
At least 24 hours since prior growth factor(s)
At least 60 days since prior biologic (antineoplastic) therapy

Prior stem cell transplantation allowed provided the following criteria are met:

More than 60 days since transplantation
Hematopoietic lab value requirements are met (See Hematopoietic)
No evidence of graft-versus-host disease (if post-allogeneic transplantation)
Prior monoclonal antibody therapy allowed (including rituximab)
No other concurrent immunomodulating agents
More than 2 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosoureas)
No other concurrent chemotherapy
No concurrent steroids (except for rituximab infusion-related symptoms)
At least 2 weeks since prior local palliative radiotherapy (small port)
At least 6 weeks since prior substantial bone marrow radiotherapy
At least 6 months since prior craniospinal radiotherapy or radiotherapy to 50% or more of the pelvis
Concurrent radiotherapy to localized painful, airway-compromising, or other acute organ-threatening lesions allowed provided at least 1 measurable lesion is not irradiated
Recovered from prior therapy
No concurrent participation in another phase II study