Chemotherapy Followed by Zevalin for Relapsed Mantle Cell Lymphoma

Inclusion Criteria

• •Histologically confirmed mantle cell lymphoma in 1st or 2nd relapse, or with persistent disease following induction therapy.
• •Measurable disease (lymph node \> 1.5 cm)
• •No anti-cancer therapy for three weeks (six weeks if Rituximab, nitrosourea or Mitomycin C) prior to study initiation, and fully recovered from all toxicities associated with prior surgery, radiation treatments, chemotherapy, or immunotherapy
• •An IRB-approved signed informed consent
• •Age \>/= 18 years
• •Expected survival \>/= 3 months
• •ECOG performance status 0, 1, or 2
• •Acceptable hematologic status within two weeks prior to registration, including: \* Absolute neutrophil count (\[segmented neutrophils + bands\] x total WBC) ≥ 1,500/mm3; \* Platelet counts ≥ 100,000/mm3
• •Female patients who are not pregnant or lactating
• •Men and women of reproductive potential who are following accepted birth control methods (as determined by the treating physician, however abstinence is not an acceptable method)
• •Patients previously on Phase II drugs if no long-term toxicity is expected, and the patient has been off the drug for eight or more weeks with no significant post treatment toxicities observed
• •Hematologic recovery from FMR (ANC \>1500, platelets \> 100,000)
• •Stable or responding disease on restaging following two cycles of FMR
• •\< 25% of bone marrow cellularity involved with lymphoma on restaging bone marrow biopsy
• •Bone marrow cellularity at least 20% (including lymphoma and normal cells)
• •Total bilirubin \< 2.0 mg/dL (if total bilirubin is \>75% indirect, then may use direct bilirubin \< 0.8 mg/dL)
• •Serum creatinine \< 2.0 mg/dL
• •No G-CSF or GM-CSF therapy within two weeks prior to Zevalin treatment, or neulasta within four weeks prior to Zevalin treatment
• •No evidence of altered biodistribution of 111-In-Zevalin as indicated by:
• •1. Absent cardiac blood pool on day 1, with high liver / spleen uptake
• •2. Lung uptake greater than blood pool on day 1 or greater than liver on day 2-3
• •3. Kidney (in posterior view) or bowel uptake greater than liver on day 2-3