• Incidence of life threatening graft-vs-host disease (GVHD) [ Designated as safety issue: Yes ]
  

• Disease response [ Designated as safety issue: No ]
  
• Progression-free and overall survival [ Designated as safety issue: No ]
  
• Acute and chronic GVHD [ Designated as safety issue: Yes ]
  
• Chimerism [ Designated as safety issue: No ]
  
• Infections [ Designated as safety issue: Yes ]
  

OBJECTIVES:

Primary

• Determine the safety of donor lymphocyte infusion, in terms of the incidence of life-threatening graft-versus-host disease (GVHD), in patients with persistent, relapsed, or progressing malignancy after nonmyeloablative allogeneic transplantation.

Secondary

• Determine disease response and progression-free and overall survival of patients treated with this regimen.
• Determine chimerism in patients treated with this regimen.
• Determine the grade of GVHD and infections in patients treated with this regimen.

OUTLINE: This is a multicenter, dose-escalation study.

Patients receive unirradiated (viable) donor lymphocyte infusion (DLI) over 15-30 minutes on day 0. Patients may receive a second infusion after 4 weeks if no graft-versus-host disease (GVHD) develops and disease worsens, or after 8 weeks if disease status is unchanged and persistent donor T cells are documented.

To determine the safety of this regimen, all patients receive a standard initial dose of DLI and then, among patients requiring a second treatment, cohorts of 5-25 patients receive decreasing doses of DLI. Acceptable safety is determined by the regimen during which no more than 15% of patients experience morbid GVHD.

Patients are followed every 2 months for 6 months, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 5-100 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

• Persistent, relapsed, or progressing malignancy
• Previously treated with a nonmyeloablative allogeneic transplantation from a related or unrelated donor comprising 2 Gy total body irradiation with or without fludarabine
• Persistent donor CD3 cells (at least 5% donor CD3 cells by fluorescent in situ hybridization or variable number of tandem repeats)
• Available leukapheresis product from the original donor of the hematopoietic cell transplantation (fresh unmodified or previously cryopreserved)
• No current grade II to IV acute graft-versus-host disease (GVHD) or extensive chronic GVHD

PATIENT CHARACTERISTICS:

Age

• Any age

Performance status

• Karnofsky 50-100%

Life expectancy

• Not specified

Hematopoietic

• See Disease Characteristics

Hepatic

• Not specified

Renal

• Not specified

PRIOR CONCURRENT THERAPY:

Biologic therapy

• See Disease Characteristics
• No concurrent imatinib mesylate or interferon alfa

Chemotherapy

• See Disease Characteristics
• At least 3 weeks since prior salvage chemotherapy

Endocrine therapy

• Concurrent steroids allowed provided patient can tolerate a taper to a dosage of no greater than 0.25 mg/kg/day within 1 to 2 weeks prior to study therapy without experiencing an increase in GVHD of at least 1 grade

Radiotherapy

• See Disease Characteristics

Surgery

• Not specified

Other

• At least 2 weeks since prior immunosuppressive therapy (e.g., cyclosporine or mycophenolate mofetil) for nonadvanced malignancy (1 week for advanced malignancy)