Iodine I 131 Monoclonal Antibody BC8 Before Autologous Stem Cell Transplant in Treating Patients With Relapsed or Refractory Hodgkin Lymphoma or Non-Hodgkin Lymphoma

PRIMARY OBJECTIVES:

I. To estimate the maximally tolerated dose of 131I-BC8 (anti-cluster of differentiation
[CD]45) (iodine I 131 monoclonal antibody BC8) that can be delivered prior to autologous stem
cell transplantation for patients with relapsed/refractory B-non-Hodgkin lymphoma (NHL),
T-NHL, or Hodgkin lymphoma (HL).

SECONDARY OBJECTIVES:

I. To optimize the protein dose (antibody [Ab]) to deliver a favorable biodistribution in the
majority of patients.

II. To assess the radiation dose delivered to tumor sites and normal organs by the above
therapy.

III. To evaluate the dose-response relationship of radiation-dose to tumor and clinical
response.

IV. To estimate the overall and progression-free survival of the above regimen in such
patients.

V. To evaluate the toxicity and tolerability of the above therapy.

VI. To evaluate the feasibility of delivering high-dose 131I-BC8 and autologous stem cell
transplantation (ASCT) to B-Cell NHL, T-NHL, and HL patients.

VII. To evaluate the ability to reduce infusion reactions via unlabeled BC8 preinfusion.

OUTLINE: This is a dose-escalation study.

Patients receive a dosimetric dose of iodine I 131 monoclonal antibody BC8 intravenously (IV)
on day -20 and a therapeutic dose on day -11. Before day -20, patients may also receive up to
2 additional dosimetric doses of iodine I 131 monoclonal antibody BC8 IV approximately 1-2
weeks apart. Patients then undergo autologous stem cell transplantation on day 0.

After completion of study treatment, patients are followed up at 1, 3, 6, and 12 months and
then annually thereafter.

Inclusion Criteria:

- Patients must have a histologically confirmed diagnosis of B-NHL, T-NHL, or HL; CD45
antigen expression must be documented on tumor specimens in all cases except HL, in
whom histologic demonstration of CD45+ cells adjacent to the Reed Sternberg cells is
required

- Patients must have received at least one prior standard systemic therapy with
documented recurrent or refractory disease

- Mantle cell lymphoma (MCL), T-NHL, or other high-risk malignancies may be
enrolled/transplanted in complete remission (CR)/first partial remission (PR1)

- Patients are preferred to have either a tumor mass amenable to core needle biopsy
during the dosimetry phase, or a measurable tumor mass with at least one site of
involvement measuring 2.0 cm in largest dimension on computed tomography (CT) imaging
for purposes of planar and/or single-photon emission CT (SPECT)/CT tumor dosimetry
(patients with disease that does not allow tumor dosimetry will be allowed on study
since they still can contribute toward achieving the primary endpoint, but these
patients will be given a lower priority over those with evaluable disease)

- Creatinine [Cr] < 2.0

- Bilirubin < 1.5 mg/dL, with the exception of patients thought to have Gilbert's
syndrome, who may have a total bilirubin above 1.5 mg/dL

- All patients eligible for therapeutic study must have a minimum of >= 4 x10^6 CD34/kg
autologous hematopoietic stem cells harvested and cryopreserved and divided into 2
aliquots of at least >= 2 x10^6 CD34/kg each; patients with a history of prior
autologous hematopoietic cell transplant (HCT) are only required to have >= 2x10^6
CD34/kg stored

- Patients must have an expected survival of > 60 days and must be free of major
infection

Exclusion Criteria:

- Circulating human anti-mouse antibody (HAMA), to be determined before each infusion

- Systemic anti-lymphoma therapy given in the previous 30 days before the scheduled
therapy dose with the exception of rituximab

- Inability to understand or give an informed consent

- Lymphoma involving the central nervous system

- Other serious medical conditions considered to represent contraindications to bone
marrow transplant (BMT) (e.g. abnormally decreased cardiac ejection fraction,
diffusion capacity of the lung for carbon monoxide (DLCO) < 50% predicted, forced
expiratory volume in one second (FEV1) < 70% predicted, acquired immune deficiency
syndrome [AIDS], etc.)

- Known human immunodeficiency virus (HIV) seropositivity

- Pregnancy or breast feeding

- Prior allogeneic bone marrow or stem cell transplant

- Prior autologous bone marrow or stem cell transplant or prior radiation therapy (RT) >
20 Gy to a critical organ within 1 year of enrollment

- Presence of circulating lymphoma cells by morphology or flow cytometry (> 0.1%) at or
near the time of peripheral blood stem cell (PBSC) collection if unpurged/unselected
PBSC are to be used (patients with cryopreserved stem cells which are negative [=<
0.1% involved] by flow cytometry will also be considered eligible)

- Southwest Oncology Group (SWOG) performance status >= 2.0

- Unable to perform self-care during radiation isolation

- Expected survival if untreated less than 60 days