Vaccine Therapy and Sargramostim Compared With Placebo and Sargramostim Following Rituximab in Treating Patients With Non-Hodgkin’s Lymphoma

DISEASE CHARACTERISTICS:

Histologically confirmed follicular B-cell non-Hodgkin's lymphoma (NHL)

Grade 1, 2, or 3

Meets 1 of the following criteria for treatment with rituximab:

Treatment naïve
Relapsed or refractory disease after prior chemotherapy
Relapsed after a prior documented response (i.e., complete or partial response) to rituximab of at least 6 months duration
Tumor accessible for biopsy OR existing biopsy material (taken within the past 6 months) suitable for vaccine preparation
Measurable or evaluable disease after tumor tissue procurement for vaccine production

No more than 2 prior treatment regimens for NHL

Single regimens include any of the following:

Maintenance rituximab
Rituximab administered once weekly for 8 courses
Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus rituximab* NOTE: *CHOP followed by rituximab at time of relapse is considered 2 treatment regimens
No history of CNS lymphoma or meningeal lymphomatosis

PATIENT CHARACTERISTICS:

Age

18 and over

Performance status

ECOG 0-1

Life expectancy

Not specified

Hematopoietic

Absolute granulocyte count ≥ 1,500/mm^3
Platelet count ≥ 75,000/mm^3 (unless related to bone marrow involvement by lymphoma)
Hemoglobin ≥ 10g/dL

Hepatic

Not specified

Renal

Not specified

Cardiovascular

No congestive heart failure

Pulmonary

No compromised pulmonary function

Immunologic

HIV negative
No prior allergic response to GM-CSF
No active bacterial, viral, or fungal infection

Other

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No psychiatric disorder that would preclude study participation
No other malignancy within the past 2 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
No other serious nonmalignant disease that would preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

See Disease Characteristics
See Chemotherapy
At least 4 weeks since prior immunotherapy
No prior radiolabeled anti-lymphoma antibody (e.g., iodine I 131 tositumomab or ibritumomab tiuxetan)
No prior autologous or allogeneic stem cell transplantation
No prior lymphoma-specific idiotype immunotherapy (e.g., Id vaccine)
No prior investigational vaccine or immunotherapeutic containing keyhole limpet hemocyanin (KLH)

Chemotherapy

See Disease Characteristics
At least 4 weeks since prior chemotherapy
More than 9 months since prior fludarabine
More than 2 years since prior chemotherapy/rituximab combination therapy (e.g., CHOP/rituximab or cyclophosphamide, vincristine, and prednisone [CVP]/rituximab)
No more than 6 total prior treatment courses with fludarabine

Endocrine therapy

No concurrent steroids for allergic reaction to sargramostim (GM-CSF)

Radiotherapy

See Biologic therapy
At least 4 weeks since prior radiotherapy

Surgery

Not specified

Other

At least 4 weeks since prior experimental therapy
No concurrent systemic immunosuppressive therapy
No other concurrent anti-lymphoma therapy