Fludarabine,Cyclophosphamide and Rituximab Followed by Zevalin for Non-Follicular Indolent Lymphomas.

Inclusion Criteria:

* Patients with a lymphoma refractory to front-line chemotherapy, not including fludarabine, or in first relapse after chemotherapy not including fludarabine, not suitable for high-dose chemotherapy supported by auto or allogeneic bone marrow transplantation.
* Histologically-confirmed small lymphocytic (SLL), lymphoplasmacytic (LPL) and marginal zone (MZL) lymphomas.
* All prior chemotherapy, including corticosteroids, had to have been completed \> 4 weeks before study treatment; \< 25% of active bone marrow irradiated previously; no prior bone marrow transplantation.
* Age: 18-70 years
* ECOG- performance status: 0-2.
* No allergy to mouse proteins.
* CD20 positive B cell lymphoma.
* Ann Arbor stage III or IV disease with bidimensionally measurable disease in at least one site which has not irradiated, including any adenopathy or mass that could be measured during a physical examination or that was \> 5 cm on a computed tomographic scan (CT). In the event of splenomegaly or hepatomegaly, extension 5 cm below the costal margin was considered evidence of measurable disease. Osteoblastic bone lesions, ascites and pleural effusion are not considered measurable disease.
* Tumor involvement in the marrow\<25% before treatment with Zevalin.
* Acceptable hematologic status within one week prior study start: Hb\>9g/dL, white blood count \>3x10\^9/L, absolute neutrophil count \>1.5x10\^9/L, platelets \>100x10\^9/L.
* Written informed consent prior to any study specific screening procedures, with the understanding that the patient has the right to withdraw from that study at any time, without prejudice.
* Patients willing and able to comply with the protocol for the duration of the study.
* Patients, if sexually active, must agree to be using effective contraception for the entire treatment period and for 1 year following treatment. Women, of child-bearing potential, must have a negative pregnancy test.

Exclusion Criteria:

* Histologies other than those included
* History of malignancy other than squamous cell carcinoma, basal cell carcinoma of the skin or carcinoma in situ of cervix within the last 5 years.
* Major surgery, other than diagnostic surgery, within the last 4 weeks.
* Presence of malignant ascites or pleural effusions.
* Evidence of CNS involvement. Patients with a history of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant and adversely affecting compliance to study drugs.
* Clinically significant cardiac disease (e.g. congestive heart failure, symptomatic coronary artery disease, cardiac arrhythmias not well controlled with medication, or myocardial infarction within the last 6 months, NYHA class III or IV heart disease), abnormal liver function tests, not disease related, within 1 week prior to study start (serum bilirubin \>2 mg/dL; ALAT \>2.5 x upper normal limit; alkaline phosphatase \>2.5xupper normal limit), abnormal renal function, not disease related (serum creatinine \>2.0 mg/dL), active opportunistic infections.
* Serum positivity for HIV, HBsAg and HCV except for those with no sign of active viral replication, assessed by HCV-RNA and HBV-DNA. This latter group of patients can be enrolled in the study, but they will receive lamivudine prophylaxis and bimonthly evaluation of HbSAg, HbCAb and HBV-DNA will be provided.