Tandem Stem Cell Transplantation for Non-Hodgkin's Lymphoma

Inclusion Criteria

• Histologically proven non-Hodgkin’s lymphoma
• High risk disease including at least one of the following: * Relapsed or refractory disease * Transformed lymphoma * Aggressive T-cell lymphoma * Failure to achieve completed remission (CR) following Auto SCT * Less than a 20% chance of event-free survival from autologous transplant determined by the treating physician and the Principal Investigator
• Eastern Cooperative Oncology Group (ECOG) performance status =< 2
• Underwent Autologous SCT 60-120 days prior to registration including: * BEAM conditioning (BCNU: 300 mg/m2 IV day -7, Etoposide: 100 mg/m2 IV BID days -6,-5,-4,-3, Cytarabine: 100 mg/m2 IV BID days -6,-5,-4,-3, Melphalan: 140 mg/m2 IV day -2) * Minimum of 2 x 10^6 CD34+ cells/kg infused
• Full hematologic recovery following Auto HCT including: * Absolute neutrophil count (ANC) >1000 ul * Platelet count of >= 50,000 ul independent of transfusion for >7 days
• Available matched related or unrelated donor; selected donor must be a complete match or have only a single antigen mismatch
• Women of child-bearing potential and sexually active males must use an accepted and effective method of birth control
• Bone marrow comprising of < 10% lymphoma on most recent biopsy/aspiration (within 9 months of Allo transplant; may have been performed prior to autologous transplant)
• Serum bilirubin =< 2 x the institutional upper limit of normal (ULN)
• Serum creatinine =< 2 x the institutional ULN and measured or estimated creatinine clearance > 60 cc/min
• Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines

Exclusion Criteria

• Prior autologous or allogeneic hematopoietic cell transplantation (other than autologous SCT 60-120 days prior to registration)
• Prior radioimmunotherapy
• Known or suspected progressive disease following autologous SCT
• Additional treatment for NHL administered from time of autologous SCT through registration
• Pregnant or breast-feeding women due to the known birth defects association with the treatments used in this study
• Patients known to be human immunodeficiency virus (HIV)-positive (the concern for opportunistic infection and hematologic reserve are considered to be significantly greater in this population)
• Any prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer or other cancer for which the patients has been disease-free for five years
• Active infection requiring oral or intravenous antibiotics