Lenalidomide and Rituximab in Treating Patients With Non-Hodgkin Lymphoma

For people ages 18 years and up

DISEASE CHARACTERISTICS:

• Histologically* confirmed non-Hodgkin lymphoma, including one of the following subtypes:
  • Grade 1, 2, or 3a (> 15 centroblasts per high-power field with centrocytes present) follicular lymphoma according to WHO criteria
  • Small lymphocytic lymphoma
• NOTE: *Bone marrow biopsies as the sole means of diagnosis are not acceptable, but they may be submitted in conjunction with nodal biopsies or extra-nodal biopsies; fine-needle aspirates are not acceptable for diagnosis.
• At least one measurable lesion according to RECIST criteria
  • Measurable lymphadenopathy to follow with serial exam and/or imaging
• Relapsed or refractory disease

  • Must have evidence of disease progression during or after last treatment

    - If previously treated with rituximab, must have disease progression within 6 months of last therapy OR if there was a prior response to rituximab, rituximab must not have been given within the past 6 months

• No evidence of CNS metastases

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Life expectancy > 3 months
• Absolute neutrophil count ≥ 1,000/mm³
• Platelet count ≥ 75,000/mm³
• Serum creatinine ≤ 2.0 mg/dL
• Total bilirubin ≤ 2.0 mg/dL
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective double method contraception for ≥ 28 days before, during, and for ≥ 28 days after completion of study therapy
• HIV negative
• Able to swallow lenalidomide
• Able to take aspirin (81 or 325 mg) daily or low molecular weight heparin as prophylactic anticoagulation
• No neuropathy ≥ grade 2
• No known active hepatitis A, B, or C
• No other malignancies within the past 5 years except treated basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast
• No serious medical condition, laboratory abnormality, or psychiatric illness that would preclude the patient from signing the informed consent form
• No condition, including the presence of laboratory abnormalities, that would preclude study participation or confound the ability to interpret study data
• No known hypersensitivity to thalidomide or rituximab
• No development of erythema nodosum, if characterized by a desquamating rash while taking thalidomide or similar drugs

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• At least 4 weeks since prior anticancer therapy, including radiotherapy, hormonal therapy, or surgery
• More than 28 days since prior experimental drug or therapy
• No prior lenalidomide
• No other concurrent anticancer agents or treatments, including radiotherapy or thalidomide
• No other concurrent investigational agents
• No concurrent sargramostim (GM-CSF)
• No other concurrent antilymphoma therapy, including steroids (except for the treatment of hypersensitivity reactions)