Fludarabine, Cyclophosphamide, and Thalidomide in Treating Patients With Angioimmunoblastic T-Cell Lymphoma

OBJECTIVES:

Primary

• Determine the response rate in patients with angioimmunoblastic T-cell lymphoma after chemotherapy comprising fludarabine and cyclophosphamide.

Secondary

• Assess the incremental anatomical and molecular response rate in these patients during treatment with thalidomide.
• Determine the toxicity of treatment with fludarabine and cyclophosphamide followed by thalidomide.
• Assess the progression-free and overall survival of these patients.
• Develop a detailed pathological description of the disease at presentation and at relapse.
• Assess the number of circulating clonal T cells at presentation and during thalidomide treatment.
• Screen for possible etiological viruses at presentation.
• Evaluate the evolution of EBV viral load during follow-up.

OUTLINE: This is a multicenter study.

Patients receive oral or IV fludarabine and oral or IV cyclophosphamide once daily on days 1-3. Courses repeat every 28 days for 4-6 courses in the absence of disease progression or unacceptable toxicity. Beginning at least 4 weeks after completion of chemotherapy, patients who achieve at least stable disease receive oral thalidomide once daily for at least 6 months.

Lymph nodes, marrow, and peripheral blood will be collected periodically for research studies.

After completion of study therapy, patients are followed up every 3 months for 2 years and then every 6 months thereafter.