Chemotherapy Plus Vaccination to Treat Mantle Cell Lymphoma

Background: * Mantle cell lymphoma presents a particular clinical challenge because it is aggressive and incurable with chemotherapy. Thus, novel treatment approaches are needed. * In follicular center cell lymphomas, another incurable disease, recent evidence suggests that molecular complete remissions may be achieved following idiotype vaccination in patients who have achieved minimal residual disease with combination chemotherapy. * These results suggest that idiotype vaccines may be able to induce a clinically significant immune response against lymphoma. Objectives: * To assess if etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (EPOCH-R)/idiotype vaccination is associated with a median progression-free survival consistent with 36 months; * To assess if rituximab affects generation of T-cell immunity against the idiotype. * To compare T-cell immunity using two different methods of isolating the idiotype protein. Eligibility: * Tissue diagnosis of mantle cell lymphoma. * Age greater than or equal to 18 years. * Previously untreated with cytotoxic chemotherapy. All stages of disease. * Lymph node of greater than or equal to 2 cm accessible for biopsy/harvest or greater than 1000/microl of circulating tumor cells in the blood. * Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 3. Design: * In the present study, we propose to investigate the efficacy of idiotype vaccine treatment in previously untreated patients with mantle cell lymphomas. In order to achieve minimal residual disease, patients will receive 6 cycles EPOCH chemotherapy and rituximab (EPOCH-R) followed by 5 idiotype vaccine injections. * This study has completed accrual of 26 patients and study is closed as of 4/18/2022.