Immunotoxin Therapy in Treating Patients With Hairy Cell Leukemia

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed refractory or recurrent hairy cell leukemia
• * Relapsed after less than 2 years of complete remission after purine analog therapy
• * Must have at least one of the following indications for therapy:
• * Progressive or massive splenomegaly
• * Cytopenia defined by the following:
• * Absolute neutrophil count less than 1,000/mm\^3 OR
• * Platelet count less than 100,000/mm\^3 OR
• * Hemoglobin less than 12 g/dL
• * More than 20,000 hairy cells/mm\^3
• * Symptomatic adenopathy
• * Constitutional symptoms including tumor-related fever or bone pain
• Evidence of CD22 positivity by 1 of the following:
• * More than 15% of malignant cells from a site must react with anti-CD22 by immunohistochemistry
• * More than 30% of malignant cells from a site CD22+ by fluorescent-activated cell sorter
• * More than 400 CD22 sites/cell (average) on malignant cells as assessed by radiolabeled anti-CD22 binding
• No CNS disease requiring treatment
• No patients whose serum neutralizes BL22 immunotoxin in tissue culture, due to either antitoxin or antimouse-IgG antibodies
• * No patients whose serum neutralizes more than 75% of the activity of 1 microgram/mL of BL22 immunotoxin
• PATIENT CHARACTERISTICS:
• Age:
• 18 and over
• Performance status:
• Karnofsky 60-100%
• Life expectancy:
• More than 6 months
• Hematopoietic:
• See Disease Characteristics
• Pancytopenia due to disease allowed
• Hepatic:
• ALT and AST less than 2.5 times upper limit of normal (ULN)
• Bilirubin less than 1.5 times ULN
• Renal:
• Creatinine no greater than 2.0 mg/dL
• Pulmonary:
• FEV1 at least 60% of predicted
• DLCO at least 55% of predicted
• Other:
• HIV negative
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• PRIOR CONCURRENT THERAPY:
• Biologic therapy:
• Prior bone marrow transplantation allowed
• At least 3 weeks since prior interferon for the malignancy
• More than 3 months since prior monoclonal antibody therapy (e.g., rituximab)
• Chemotherapy:
• See Disease Characteristics
• At least 3 weeks since prior cytotoxic chemotherapy for the malignancy
• Endocrine therapy:
• Not specified
• Radiotherapy:
• At least 3 weeks since prior whole body electron beam radiotherapy for the malignancy
• Radiotherapy within the past 3 weeks allowed provided less than 10% of total bone marrow was treated and patient has measurable disease outside the radiation port
• Surgery:
• Not specified
• Other:
• At least 3 weeks since prior retinoids for the malignancy
• At least 3 weeks since any other prior systemic therapy for the malignancy
• No concurrent therapeutic warfarin