Rituximab, Alemtuzumab, and GM-CSF As First-Line Therapy in Treating Patients With Early-Stage Chronic Lymphocytic Leukemia

DISEASE CHARACTERISTICS:

* Diagnosis of chronic lymphocytic leukemia (CLL) meeting the following criteria:

  * Minimum threshold peripheral blood lymphocyte count 5 x 10\^9/L
  * Monoclonality (light chain exclusion) of B lymphocytes detected by immunophenotyping (CD19-positive), demonstrating ≥ 3 of the following characteristics:

    * CD5-positive
    * CD23-positive
    * Dim surface light chain expression
    * Dim surface CD20 expression
  * Negative for IGH/CCND1 translocation AND/OR immunostaining is negative for cyclin D1 expression by fluorescent in-situ hybridization (FISH) analysis
  * Rai stage 0, I, or II disease that does not meet standard NCI-Working Group criteria for treatment of CLL
* Poor prognosis as defined by ≥ 1 of the following factors:

  * Unmutated IgVH mutation status AND CD38 expression (i.e., ≥ 30% cells positive on flow cytometry)
  * Unmutated IgVH mutation status AND ZAP-70 expression (i.e., ≥ 20% cells positive on flow cytometry)
  * VH3-21 gene segment use irrespective of mutation status AND CD38 expression (≥ 30% cells positive on flow cytometry)
  * VH3-21 gene segment use irrespective of mutation status AND ZAP-70 expression (≥ 20% cells positive on flow cytometry)
  * 11q-negative\*
  * 17p-negative\* NOTE: \*Determination of IgVH mutation status is not required in patients whose eligibility is based on 17p13- or 11q22- deletions

PATIENT CHARACTERISTICS:

* ECOG performance status 0- 2
* Creatinine ≤ 1.5 times upper limit of normal (ULN)
* Total bilirubin ≤ 3.0 times ULN OR direct bilirubin ≤ 1.5 ULN
* AST ≤ 3.0 times ULN (unless due to hemolysis or CLL)
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must practice effective contraception
* Willing to provide mandatory blood samples (for patients at the Mayo Clinic in Rochester only) for research studies as required by the protocol
* No comorbid conditions, including any of the following:

  * New York Heart Association Class III or IV heart disease
  * Myocardial infarction within the past month
  * Uncontrolled infection
  * HIV infection or AIDS
  * Serological evidence of active hepatitis B infection (i.e., serum antigen or e-antigen positivity) or positive hepatitis C serology
* No other active primary malignancy requiring treatment or limiting survival to ≤ 2 years
* No active autoimmune hemolytic anemia, immune thrombocytopenia, or pure red blood cell aplasia

PRIOR CONCURRENT THERAPY:

* More than 4 weeks since prior major surgery
* No prior chemotherapy or monoclonal antibody treatment for CLL
* No concurrent corticosteroids