DT2219ARL for Relapsed or Refractory CD19 (+), CD 22 (+) B-Lineage Leukemia Or Lymphoma

Inclusion Criteria:

Histologic verification of B-cell lineage leukemia or B cell non-Hodgkin lymphoma and evidence of relapse/refractory disease with the presence of CD19 and/or CD22 by flow cytometry or immunohistochemistry of bone marrow aspirate, peripheral blood or node biopsy
Disease refractory to conventional therapy and other therapies of higher priority
Age ≥ 12 years
Karnofsky Performance status of ≥ 60% or, if less than 16 years of age, Lansky Play Score of ≥ 60 (appendix II)
Patients must have recovered from effects of prior therapy - at least 2 weeks should have elapsed since the last dose of chemotherapy; however patients who have recovered from the effects of previous treatment and have a >50% rise in peripheral blast count (confirmed twice) or > 50% growth of lymph nodes are immediately eligible - Patients who have relapsed following autologous or allogeneic BMT are eligible
In order to prevent tumor lysis syndrome, leukemia patients must have a peripheral blast count under 50 x 109/L. This should be achieved with hydroxyurea cytoreduction, prior to starting DT2219ARL as follows - patients with peripheral blasts and a WBC >50 x 109/L, give hydroxyurea 1-5 g daily for up to 5 days to reduce WBC below 50 x 109/L

Adequate organ function within 14 days (30 days for cardiac and pulmonary) of treatment start defined as:

Creatinine: ≤ 1.5 x upper limit of institutional normal (ULN)
Hepatic: SGOT (AST) or SGPT (ALT) < 2.5 x ULN and total bilirubin General health: Serum albumin ≥ 3.0g/dL
Pulmonary: PFTs > 50% if symptomatic or prior known impairment
Cardiac: LVEF by ECHO or MUGA ≥ 40%
Agrees to stay within the Twin Cities metropolitan area (i.e. within 30 miles of the study center) for the duration of the treatment (at least 24 hours after the last dose) and 2) have a capable caregiver
Women of childbearing potential and men should be advised and agree to practice effective methods of contraception during the course of study
Voluntary written consent

Exclusion Criteria:

Presence of leukemic or infectious pulmonary parenchymal disease
Presence of active CNS leukemia. CSF with <5 WBC/uL will not exclude the patient
Presence of any uncontrolled systemic infection
Documented uncontrolled seizure disorder or abnormal neurological examination - a seizure disorder controlled with medication (i.e. no seizures in the previous 6 months) will not exclude a patient
Documented penicillin or cephalosporin allergies
Pregnant or lactating - Women of child bearing potential must have a negative pregnancy test within 14 days of study treatment start