Alemtuzumab and Rituximab in Treating Patients With High-Risk, Early-Stage Chronic Lymphocytic Leukemia

DISEASE CHARACTERISTICS:

\* Diagnosis of B-cell chronic lymphocytic leukemia (CLL)

\- Early-stage, biologically high-risk disease defined by the following criteria:

* Rai stage 0-II (does not meet standard NCI-sponsored Working Group criteria for treatment)
* Clinical and phenotypic features manifested in the peripheral blood, including the following:

  * Minimum threshold peripheral blood lymphocyte count of \> 5,000/mm³
  * Small-to-moderate peripheral blood lymphocytes with ≤ 55% prolymphocytes
  * Monoclonality of B lymphocytes by immunophenotypic evaluation, demonstrating co-expression of CD19, CD5, and CD23 antigens, surface expression of CD20 and CD52, and B-cell monoclonal population defined by light-chain exclusions
* Poor prognosis demonstrated by ≥ 1 of the following high-risk parameters:

  * Unmutated human immunoglobulin variable region heavy chain (IgVH) gene and CD38 expression (≥ 30% cells positive on flow cytometry) OR unmutated IgVH ZAP-70 expression (≥ 20% cells positive on flow cytometry) = 11q- = 17p-

PATIENT CHARACTERISTICS:

* ECOG performance status 0-2
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* Creatinine ≤ 1.5 times upper limit of normal (ULN)
* Total bilirubin ≤ 3.0 times ULN OR direct bilirubin ≤ 1.5 times ULN
* AST ≤ 3.0 times ULN (unless due to hemolysis or CLL)
* Hemoglobin ≥ 9.0 g/dL
* No New York Heart Association class III-IV heart disease
* No myocardial infarction within the past month
* No uncontrolled infection
* No active HIV infection
* No evidence of autoimmune hemolytic anemia, immune thrombocytopenia, or pure red blood cell aplasia
* No other active primary malignancy requiring treatment or limiting survival to less than 2 years

PRIOR CONCURRENT THERAPY:

* No prior treatment for CLL
* Prior corticosteroids allowed
* No prior radiotherapy
* More than 4 weeks since prior major surgery