Rituximab in Treating Patients With Low Tumor Burden Indolent Non-Hodgkin's Lymphoma

INCLUSION CRITERIA:

   - Histologically confirmed non-Hodgkin's lymphoma, including 1 of the following:

      - Follicular grade 1 or 2

      - Small lymphocytic

      - Marginal zone (nodal)

      - Marginal zone (splenic)

      - Mucosa-associated lymphoid tissue (MALT)

   - Stage III or IV disease

   - Must meet the following criteria for low tumor burden:

      - No nodal or extranodal mass at least 7 cm

      - Less than 3 nodal masses greater than 3 cm in diameter

      - No systemic symptoms or B symptoms

      - No splenomegaly greater than 16 cm by a computed tomography (CT) scan

      - No evidence of risk of compression of a vital organ (i.e., ureteral or epidural)

      - No leukemic phase with greater than 5,000/mm^3 circulating lymphocytes

      - No cytopenias, defined as any of the following:

         - Platelet count less than 100,000/mm^3

         - Hemoglobin less than 10 g/dL

         - Absolute neutrophil count less than 1,500/mm^3

   - At least 1 objective measurable disease parameter

      - Abnormal positron emission tomography (PET) scans will not constitute evaluable
      disease unless verified by CT scan or other appropriate imaging

   - Age: 18 and over

   - Eastern Cooperative Oncology Group (ECOG) performance status 0-1

   - Must meet the following criteria for labs:

      - Hematopoietic

         - Absolute neutrophil count at least 1,500/mm^3*

         - Hemoglobin at least 10 g/dL*

         - Platelet count at least 100,000/mm^3*

         - NOTE: *Without growth factor and/or transfusion support

      - Hepatic

         - Bilirubin no greater than 2 times upper limit of normal (ULN) OR direct
         bilirubin normal for patients with Gilbert's Syndrome

         - The aspartate transaminase (AST) and alanine transaminase (ALT) ratio
         (AST/ALT) no greater than 5 times ULN

         - Hepatitis B surface antigen negative

      - Renal

         - Creatinine no greater than 2 times ULN

EXCLUSION CRITERIA:

   - Evidence of transformation to a large cell histology

   - Pregnant or nursing. Fertile patients must use effective contraception

   - HIV positive

   - Uncontrolled active infection

   - Other malignancy within the past 2 years except adequately treated basal cell or
   squamous cell skin cancer or carcinoma in situ of the cervix

   - Prior immunotherapy for lymphoma

   - Prior chemotherapy for lymphoma

   - Concurrent chemotherapy

   - Prior radiotherapy for lymphoma

   - Concurrent radiotherapy

   - Concurrent radioimmunotherapy