CpG 7909, Rituximab, and Yttrium Y 90 Ibritumomab Tiuxetan in Treating Patients With Non-Hodgkin's Lymphoma That is Recurrent or Did Not Respond to Previous Treatment

DISEASE CHARACTERISTICS:

• Histologically confirmed non-Hodgkin's lymphoma, including the following subtypes:

  • Small lymphocytic lymphoma*
  • Lymphoplasmacytoid lymphoma*
  • Grade 1, 2, or 3 follicular lymphoma*
  • Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue*
  • Nodal marginal zone B-cell lymphoma*
  • Splenic marginal zone B-cell lymphoma*
  • Mantle cell lymphoma*
  • Diffuse large cell lymphoma
  • Transformed lymphoma NOTE: *Closed to accrual as of 10/29/07
• Recurrent, refractory, or residual disease
• CD20-positive disease
• Bidimensionally measurable disease (≥ 1 lesion that has a single diameter of ≥ 2 cm)
• Must have < 25% bone marrow involvement of cellular marrow with lymphoma, as determined by bilateral bone marrow aspirate and biopsy
• No marrow cellularity ≤ 15% (as determined on all bone marrow samples)
• No prior failed stem cell collection
• No CNS lymphoma
• No lymphoma related to HIV or AIDS
• No myelodysplastic syndromes or marrow chromosomal changes suggesting myelodysplasia

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Life expectancy ≥ 3 months
• Absolute neutrophil count ≥ 1,500/mm³
• Platelet count ≥ 150,000/mm³
• Lymphocyte count < 5,000/mm³ (only for patients with small lymphocytic lymphoma)
• Hemoglobin ≥ 8 g/dL
• Total bilirubin ≤ 2 times upper limit of normal (ULN) OR direct bilirubin ≤ 1.5 times ULN
• Creatinine ≤ 2 mg/dL
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No serious nonmalignant disease (e.g., active infection) or other condition that would preclude study participation
• No other active primary malignancy
• No known human antimouse antibodies or human antichimeric antibodies
• No skin rash (e.g., Stevens-Johnson's syndrome or toxic epidermal necrolysis) after receiving rituximab

• No pre-existing clinical autoimmune or antibody-mediated diseases*, including any of the following:

  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Multiple sclerosis
  • Sjögren's syndrome
  • Autoimmune thrombocytopenia
• NOTE: *If no clinical symptoms, but only previously detected antibodies, then not excluded.

PRIOR CONCURRENT THERAPY:

• More than 1 week since prior filgrastim (G-CSF) or sargramostim (GM-CSF) (3 weeks for pegfilgrastim)
• More than 3 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosoureas or mitomycin C)
• More than 4 weeks since prior major surgery, except for diagnostic surgery
• More than 6 weeks since prior rituximab
• No prior external-beam radiotherapy to > 25% of active bone marrow
• No prior myeloablative therapies with autologous or allogeneic bone marrow transplantation or peripheral blood stem cell support
• No prior radioimmunotherapy, including yttrium Y 90 ibritumomab tiuxetan, tositumomab, or iodine I 131 monoclonal antibody Lym-1
• No concurrent myelosuppressive chemotherapy
• No concurrent corticosteroid therapy, except prednisone (< 20 mg) for benign causes