Fludarabine and Cyclophosphamide Followed By LMB-2 Immunotoxin in Treating Patients With Hodgkin's Lymphoma

DISEASE CHARACTERISTICS:

• Histopathologically confirmed CD25+ Hodgkin's lymphoma

  • At least 20% of the malignant cells positive by immunohistochemistry
  • Stage II-IV disease

• Meets the following criteria:

  • Failed standard chemotherapy
  • Not eligible for curative salvage radiotherapy or chemotherapy
  • Not eligible for or refused bone marrow transplantation
• Measurable disease
• No patient whose serum neutralizes LMB-2 immunotoxin in tissue culture, due either to antitoxin or antimouse-IgG antibodies
• No patient whose serum neutralizes > 75% of the activity of 1 µg/mL of LMB-2 immunotoxin

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Absolute neutrophil count ≥ 1,000/mm³
• Platelet count ≥ 50,000/mm³
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• ALT and AST ≤ 2.5 times upper limit of normal
• Albumin ≥ 3.0 g/dL
• Bilirubin ≤ 2.2 mg/dL (\< 5 mg/dL if Gilbert's syndrome is present)
• Creatinine ≤ 1.4 mg/dL OR creatinine clearance ≥ 50 mL/min

• No uncontrolled intercurrent illness including, but not limited to, any of the following:

  • Ongoing or active infection
  • Symptomatic congestive heart failure
  • Unstable angina pectoris
  • Cardiac arrhythmia
  • Psychiatric illness or social situations that would limit study compliance

• No HIV or hepatitis C positivity

  • Hepatitis B surface antigen positivity allowed provided patient is receiving lamivudine
• LVEF ≥ 45%
• DLCO ≥ 50% of normal OR FEV_1 ≥ 60% of normal
• No active second malignancy requiring treatment

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No systemic cytotoxic chemotherapy within the past 4 weeks
• No systemic steroids (except stable doses of prednisone ≤ 20 mg/day) within the past 4 weeks
• No monoclonal antibody therapy within the past 12 weeks
• No prior LMB-2 immunotoxin
• No concurrent warfarin