Gemcitabine and Bendamustine in Patients With Relapsed or Refractory Hodgkin’s Lymphoma

Inclusion Criteria:

Histologically documented Classical Hodgkin's lymphoma that is recurrent or refractory after standard chemotherapy; core biopsies are acceptable if they contain adequate tissue for primary diagnosis and immunophenotyping; bone marrow biopsies as the sole means of diagnosis are not acceptable

Patients with Hodgkin's lymphoma may have one of the following World Health Organization subtypes:

Nodular sclerosis Hodgkin's lymphoma
Lymphocyte-rich Hodgkin's lymphoma
Mixed cellularity Hodgkin's lymphoma
Lymphocyte depletion Hodgkin's lymphoma
Nodular lymphocyte predominant Hodgkin's lymphoma
Patients must have relapsed or progressed after at least one prior therapy
Patients with relapsed or refractory disease following stem cell transplantation are permitted
No prior treatment with bendamustine; prior therapy with gemcitabine is permitted
Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
Measurable disease must be present either on physical examination or imaging studies; non-measurable disease alone is not acceptable
Measurable disease: lesions that can be accurately measured in at least two dimensions as >= 1.0 x 1.0 cm by computerized tomography (CT), PET/CT (positron emission tomography/CT), or magnetic resonance imaging (MRI)

Non-measurable disease: all other lesions, including small lesions (less than 1.0 x 1.0 cm) and truly non-measurable lesions; lesions that are considered non-measurable include the following:

Bone lesions (lesions if present should be noted)
Ascites
Pleural/pericardial effusion
Lymphangitis cutis/pulmonis
Bone marrow (involvement by Hodgkin's lymphoma should be noted)
Non-pregnant and non-nursing; due to the teratogenic potential of these agents, pregnant or nursing patients may not be enrolled; women and men of reproductive potential should agree to use an effective means of birth control

Patients with human immunodeficiency virus (HIV) infection are eligible; patients with HIV infection must meet the following: No evidence of co-infection with hepatitis B or C; cluster of differentiation (CD)4+ count >= 400/mm; no evidence of resistant strains of HIV; on anti-HIV therapy with an HIV viral load < 50 copies HIV ribonucleic acid (RNA)/mL; no history of acquired immune deficiency syndrome (AIDS) defining conditions

Granulocytes >= 1000/μl
Platelet count >= 75,000/μl
Creatinine =< 20 mg/dL
Bilirubin =< 2.0 mg/dL
Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.0 x upper limits of normal