RATIONALE: Biological therapies such as beta alethine use different ways to stimulate the
immune system and stop cancer cells from growing.
PURPOSE: Phase I/II trial to study the effectiveness of beta alethine in treating patients
who have Waldenstrom's macroglobulinemia.
- Determine the antitumor effects of low-dose beta alethine in patients with
- Determine the effects of this drug on anemia, performance status, and disease symptoms
in these patients.
- Determine the effects of this drug on the immune system of these patients.
- Determine the safety of this drug in these patients.
OUTLINE: This is a multicenter study.
Patients receive beta alethine subcutaneously on days 1, 15, 29, 43, 57, and 71. Courses
repeat every 85 days in the absence of disease progression or unacceptable toxicity.
Patients are followed for 30 days.
PROJECTED ACCRUAL: A total of 13-37 patients will be accrued for this study.
- Confirmed diagnosis of Waldenstrom's macroglobulinemia
- Urine or serum protein electrophoresis showing a measurable monoclonal spike
- Indolent disease not yet requiring therapy allowed
- Positive delayed-type hypersensitivity (DTH) response
- Induration greater than 2 mm for at least 1 antigen
- No clinical signs or evidence of active brain involvement or leptomeningeal disease
- 18 and over
- Karnofsky 50-100%
- At least 4 months
- Neutrophil count at least 1,500/mm3
- Platelet count at least 100,000/mm3
- Hemoglobin at least 10 g/dL
- Albumin at least 3.5 g/dL
- Bilirubin less than 2.0 mg/dL
- Transaminases no greater than 2.5 times upper limit of normal
- Creatinine no greater than 2.0 mg/dL
- Creatinine clearance at least 60 mL/min
- No acute changes on EKG
- No uncontrolled angina
- No heart failure
- No arrhythmia
- Adequate nutritional intake as evidenced by total protein at least 60 g/L
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No concurrent gastrointestinal bleed
- No active bacterial infections such as abscess or with fistulae
- HIV negative
- No other concurrent non-malignant disease that would preclude study
- No history of alcoholism, drug addiction, or psychotic disorders that would preclude
PRIOR CONCURRENT THERAPY:
- More than 4 weeks since prior immunotherapy
- More than 4 weeks since prior cytokines
- More than 4 weeks since prior plasmapheresis or plasma exchange
- No prior stem cell or bone marrow transplant
- More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas, mitomycin, or
- No prior intensive chemotherapy with stem cell support
- More than 4 weeks since prior corticosteroids
- No concurrent corticosteroids
- More than 4 weeks since prior radiotherapy involving more than 25% of bone marrow
- Recovered from any prior surgery
- No prior organ transplant
- No other concurrent investigational agent
- No concurrent immunosuppressants
- No concurrent anti-inflammatory agents including aspirin and non-steroidal