Chemotherapy, Radiation Therapy, Rituximab, and Umbilical Cord Blood Transplant in Treating Patients With B-Cell Non-Hodgkin's Lymphoma

DISEASE CHARACTERISTICS:

• Diagnosis of 1 of the following:
• CD20+* aggressive B-cell non-Hodgkin's lymphoma (NHL), including 1 of the following:
• Diffuse large cell (DLC) NHL meeting 1 of the following criteria:
• Relapsed disease after initial therapy but failed to mobilize or had bone marrow involvement and therefore is not suitable for an autologous stem cell transplantation
• High-intermediate or high-risk, second-line, age-adjusted International Prognostic Index (IPI) score and in second complete remission (CR) or partial remission (PR) after prior autologous stem cell transplantation
• Failed prior autologous stem cell transplantation and in at least PR after salvage chemotherapy
• Large cell transformation of indolent NHL/chronic lymphocytic leukemia (CLL) meeting the following criteria:
• CR/PR of the large cell component of disease after salvage chemotherapy or autologous stem cell transplantation
• Mantle cell lymphoma meeting 1 of the following criteria:
• High-risk, as defined by p53 positivity and in first CR/PR after initial therapy
• Relapsed disease after initial therapy and in second or third CR/PR after salvage chemotherapy
• CD20+* indolent NHL or CLL meeting the following criteria:
• Must be in second or subsequent progression (pre-allograft cytoreduction necessary but CR/PR not required)
• Indolent NHL includes, but is not limited to, any of the following:
• Follicular NHL
• Small cell NHL
• Marginal zone NHL NOTE: *CD20 positivity must be demonstrated within the past 12 months
• Relapsed disease must be biopsy proven
• Prior pre-allograft cytoreduction may have included 1 of the following:
• Single autologous stem cell transplantation with high-dose chemotherapy conditioning, if appropriate, and no conditioning prior to transplantation
• Two or more courses of intensive combination chemotherapy (e.g., rituximab, irinotecan hydrochloride, cetuximab, epirubicin hydrochloride [RICE]) as appropriate according to diagnosis and prior therapy
• Heavily pre-treated CLL patients in whom further combination chemotherapy is not appropriate may receive single-agent intermediate-dose cyclophosphamide for 2-3 courses
• No mantle cell or DLC NHL with progressive disease at allograft work-up
• No suitable matched related or unrelated donor available
• Two umbilical cord blood (UCB) units available meeting the following criteria:
• Units and recipient must be ≥ 4/6 HLA-A and -B antigen and DRB1 allele matched
• Each unit must have ≥ 1.5 x 10^7 total nucleated cells/recipient body weight

PATIENT CHARACTERISTICS:

• Karnofsky performance score 70-100%
• Creatinine clearance ≥ 50 mL/min
• Bilirubin < 2.5 mg/dL
• AST and ALT ≤ 3 times upper limit of normal (unless due to benign congenital hyperbilirubinemia)
• Spirometry and corrected DLCO ≥ 50% normal
• LVEF ≥ 40%
• Albumin ≥ 2.5 g/dL
• No active and uncontrolled infection at time of transplantation, including active infection with Aspergillus or other mold
• No HIV positivity
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No more than 120 days since prior autologous stem cell transplantation
• No more than 60 days since prior chemotherapy
• No prior allogeneic transplantation