Rituximab, Bendamustine and Melphalan Chemo-immunotherapy Followed by Reinfusion of One's Own Stem Cell for Treatment of B-cell Lymphoma in Elderly Patients

Inclusion Criteria:

Phase I eligibility:

- Any - B-cell non-Hodgkin lymphoma would be eligible for phase I portion of the study.

Phase II eligibility:

- Histologically confirmed diagnosis of rel/ref DLBCL, or diffuse large B cell lymphoma
transformed from an indolent lymphoma Since the endpoint of the Phase I portion is
safety, any B-cell NHL can be enrolled. However, the PFS endpoint varies greatly
amongst different types of lymphoma. In order to accurately interpret the survival
data, a homogeneous cohort of patients with DLBCL will be evaluated. DLBCL is the most
aggressive B-NHL with limited options. Other B-NHL's are generally more indolent and
have more options available to them.

Additional eligibility for both the phase I and phase II studies:

- Age ≥ 70 at the time of enrollment

- Hematopoietic Stem Cell Transplant Comorbidity Index (HCT-CI) ≥ 3

- KPS ≥ 70

- Males must agree to use an acceptable form of contraception per institutional
practices.

- Complete or partial response to salvage chemotherapy by IWG Working Group Criteria

- Cardiac ejection fraction of ≥ 45%

- Hemoglobin-adjusted diffusing capacity of carbon monoxide (DLCO) of ≥45%

- Creatinine clearance of ≥50 mL/min

- Completion of most recent salvage therapy within 8 weeks of enrollment

- Direct bilirubin ≤2.0 mg/dL in the absence of suspected Gilbert's disease (if
Gilbert's disease is suspected, the total bilirubin must be ≤3.0 mg/dL), and AST ≤ 2.5
ULN.

Exclusion Criteria:

- Disease progression by IWG Working Group Criteria since last therapy

- Patients with history of CNS involvement

- Prior autologous or allogeneic stem cell transplantation

- Patients who have failed bendamustine-based regimen previously

- Patients within 6 months of MI and stroke will be excluded