OBJECTIVES:

      Primary

        -  To determine the feasibility of adding alemtuzumab to standard cyclophosphamide,
           doxorubicin hydrochloride, vincristine, and oral prednisolone (CHOP) chemotherapy in
           patients with stage I-IV peripheral T-cell lymphoma (PTCL).

        -  To assess the side effect profile and early and late toxicities of this regimen in a
           standard dose-escalation design, and to establish an appropriate dose level for future
           studies.

      Secondary

        -  To document response rates and disease-free survival of patients treated with this
           regimen, and to compare these findings with those of historical controls.

        -  To monitor immune reconstitution after therapy.

        -  To determine the pharmacokinetics of subcutaneous alemtuzumab when given in combination
           with CHOP chemotherapy.

        -  To more clearly define the CD52 expression profile in these tumors and to investigate
           phenotypic variations in PTCL.

        -  To document changes (if any) in levels of Epstein-Barr virus copy number by polymerase
           chain reaction during CHOP-alemtuzumab therapy.

      OUTLINE: This is a multicenter, dose escalation of alemtuzumab study.

      Patients receive CHOP chemotherapy comprising cyclophosphamide IV, doxorubicin hydrochloride
      IV, and vincristine IV on day 1 and oral prednisone on days 1-5. Patients also receive
      alemtuzumab subcutaneously (SC) 1-3 times a week for up to 6 doses per course. Treatment
      repeats every 3 weeks for up to 8 courses in the absence of disease progression or
      unacceptable toxicity.

      Patients undergo blood collection at baseline, periodically during study treatment, and after
      completion of study therapy for pharmacokinetics and other correlative studies to monitor
      cellular immunity. Blood samples are examined by polymerase chain reaction to detect
      cytomegalovirus antigen and to monitor Epstein-Barr virus copy number. Samples are also
      analyzed by flow cytometry to quantify circulating B- and T-cells, NK-cells, monocytes, and
      dendritic-cells.

      After completion of study therapy, patients are followed every 3 months for the first year,
      every 6 months for the second year, and then yearly thereafter.