This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The use of high dose chemotherapy with autologous stem cell support has been widely employed in the treatment of relapsed lymphoma. In chemotherapy sensitive lymphoma patients, autologous transplantation can result in high remission rates. However, many patients who achieve a complete transplantation can result in high remission rates. However, many patients who achieve a complete response following transplantation will relapse and die of their disease. Most patients relapse at sites of previous bulk disease, suggesting that the primary reason for treatment failure is inability to eradicate chmotherapy resistant clogenic tumor. An inadequately functioning immune system may contribute to early cases of relapse, especially in patients who fail to achieve a complete remission following autologous transplantation. The main advantage of autolous cellular immunotherapy is that there are no allogeneic differences since the patient serves as the cell donor. Therefore, morbidity and mortality from graft vs. host disease and other complications due to allogeneic disparity can be avoided. In previous post-transplant clinical studies at the University of Minnesota, we have demonstrated that subcutaneous IL-2 and either IL-2 ctivated cells of IL-2 bolus infusions can be safely adminstered in the outpatient setting following autologous transplantation, and generates PBMNC with enhanced cytotoxicity against NK resistant lymphoma targets. However, with this dose and schedule of administration of IL-2, no improvement in patient disease outcomes was noted. The goal of the current study is to evaluate the safety of IL-2 and Rituximab, a monoclonal antibody with demonstrated efficacy against lymphoma, when used in combination to enhance immune reconstitution after autologous transplantation. The role of the GCRC in this project will include 1) administration of intravenous Rituximab (Rituxan) by 4 consecutive weekly infusions, 2) patient education in the administration of subcutaneous IL-2, 3 assessment of toxicity.
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