Pentostatin, Cyclophosphamide, and Rituximab in Treating Patients With Previously Untreated Chronic Lymphocytic Leukemia

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of chronic lymphocytic leukemia (CLL), as evidenced by an absolute lymphocytosis in the blood of at least 5,000 lymphocytes per microliter OR bone marrow lymphocytosis ≥ 30% of all nucleated cells
• •* Previously untreated disease
• •Meets 1 of the following risk criteria as defined by the three-stage Rai system
• •* Intermediate-risk disease
• •* Must meet the criteria for active disease as defined by the NCI Working Group guidelines including the following:
• •* Weight loss
• •* Fatigue
• •* Fevers
• •* Evidence of progressive marrow failure
• •* Splenomegaly
• •* Progressive lymphadenopathy
• •* Progressive lymphocytosis with a rapid doubling time
• •* High-risk disease
• •Malignant lymphocytes must demonstrate B-cells via immunophenotypic or immunohistochemical analysis
• •Patients with small lymphocytic lymphoma (CLL type) are eligible
• •PATIENT CHARACTERISTICS:
• •Karnofsky performance status 60-100%
• •Total bilirubin ≤ 2.0 mg/dL (patients with Gilbert disease or autoimmune hemolytic anemia should have an evaluation for other causes of hyperbilirubinemia, but if none are found they may be enrolled regardless of serum bilirubin)
• •Total creatinine ≤ 2.0 mg/dL OR creatinine clearance \> 50 mL/min
• •Not pregnant or nursing
• •Fertile patients must use effective contraception
• •Patients with autoimmune hemolytic anemia or autoimmune thrombocytopenia are eligible for treatment on this protocol regardless of disease stage