Bortezomib in Treating Patients With Waldenstrom's Macroglobulinemia

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of Waldenstrom's macroglobulinemia confirmed by immunofixation or immunoelectrophoresis
• •* Newly diagnosed or untreated with IgM ≥ 20 g/L OR
• •* Previously treated with IgM ≥ 5 g/L
• •Non-refractory, defined as no disease progression during prior therapy or within 4 weeks of the last dose of most recent prior therapy (12 weeks for rituximab)
• •Must have 1 or more of the following:
• •* Symptomatic lymphadenopathy
• •* Hepatomegaly and/or splenomegaly
• •* Anemia (i.e., hemoglobin \< 11.0 g/dL)
• •* Hyperviscosity syndrome
• •No other lymphoproliferative disease including transformed aggressive lymphoma
• •PATIENT CHARACTERISTICS:
• •Age
• •18 and over
• •Performance status
• •ECOG 0-2
• •Life expectancy
• •At least 12 weeks
• •Hematopoietic
• •See Disease Characteristics
• •Absolute granulocyte count ≥ 1,000/mm\^3
• •Platelet count ≥ 50,000/mm\^3
• •Hepatic
• •Bilirubin ≤ 1.5 times upper limit of normal (ULN)
• •AST or ALT ≤ 2.5 times ULN
• •Renal
• •Creatinine ≤ 1.5 times ULN
• •Other
• •No uncontrolled bacterial, fungal, or viral infection
• •No pre-existing sensory or motor neurotoxicity grade 2 or greater
• •No other prior malignancy except adequately treated nonmelanoma skin cancer, curatively treated carcinoma in situ of the cervix, or other curatively treated solid tumor for which patient has been disease free for at least 5 years
• •No other serious illness or medical condition that would preclude study participation
• •No unreasonable geographical limitations
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •See Chemotherapy
• •See Disease Characteristics
• •At least 12 weeks since prior rituximab (for patients who have progressed)
• •At least 24 weeks since prior rituximab (for patients who have not progressed)
• •No prior high-dose chemotherapy and stem cell transplantation
• •No prior radioactive monoclonal antibodies
• •Chemotherapy
• •See Disease Characteristics
• •See Biologic therapy
• •At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
• •No more than 2 prior chemotherapy regimens
• •* The same chemotherapy combination given for first-line and second-line therapy is considered 2 regimens
• •* Single-agent rituximab not considered 1 prior regimen
• •No concurrent cytotoxic chemotherapy
• •Endocrine therapy
• •No concurrent corticosteroids
• •Radiotherapy
• •At least 4 weeks since prior radiotherapy (except for low-dose, non- myelosuppressive radiotherapy) and recovered
• •No prior radiotherapy to more than 25% of bone marrow
• •Surgery
• •At least 4 weeks since prior major surgery
• •Other
• •At least 4 weeks since prior plasmapheresis
• •At least 4 weeks since prior investigational anticancer therapy
• •No other concurrent investigational anticancer agents or therapies