Ofatumumab, Pentostatin, and Cyclophosphamide in Treating Patients With Untreated Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

Inclusion Criteria

• Diagnosis of CLL according to the National Cancer Institute (NCI) criteria or SLL according to the World Health Organization (WHO) criteria, including previous documentation of:
• Biopsy-proven SLL
• Diagnosis of CLL according to NCI working group criteria as evidenced by all of the following:
• Peripheral blood lymphocyte count of > 5,000/mm^3 consisting of small to moderate size lymphocytes, with 10% within the previous 6 months
• Extreme fatigue attributed to CLL
• Fevers > 100.5 degree Fahrenheit for 2 weeks without evidence of infection
• Drenching night sweats without evidence of infection
• Progressive lymphocytosis due to CLL with an increase of > 50% over a two-month period or an anticipated doubling time of less than six months
• Prior chemotherapy or monoclonal antibody based therapy for treatment of CLL will be considered prior therapy; nutraceutical treatments with no established benefit in CLL (such as epigallocatechin gallate [EGCG], found in green tea or other herbal treatments) will not be considered "prior treatment"
• Marked hypogammaglobulinemia or the development of a monoclonal protein in the absence of any of the above criteria for active disease are not sufficient for protocol therapy
• Serum creatinine = 1.5 x UNL, a direct bilirubin should be performed and must be < 1.5 mg/dL for Gilbert's to be diagnosed
• Aspartate aminotransferase (AST) =< 3.0 x UNL and alanine aminotransferase (ALT) =< 3.0 x UNL (unless due to hemolysis or CLL)
• Eastern Cooperative Oncology Group (ECOG) performance status (PS): 0, 1, or 2
• Willingness to provide blood samples as required
• Able to adhere to the study visit schedule and other protocol requirements

Exclusion Criteria

• Any of the following comorbid conditions:
• New York Heart Association Class III or IV heart disease
• Recent myocardial infarction (< 1 month)
• Uncontrolled infection
• Infection with the human immunodeficiency virus (HIV/acquired immunodeficiency syndrome [AIDS])
• Infection with known chronic, active Hepatitis C
• Positive serology for hepatitis B (HB) defined as a positive test for HB surface antigen (HBsAg); in addition, if negative for HBsAg but HB core antibody (HBcAb) positive (regardless of HBsAb status), a HB deoxyribonucleic acid (DNA) test will be performed and if positive the subject will be excluded
• Pregnant women
• Nursing women
• Men or women of childbearing potential who are unwilling to employ adequate contraception
• Other active primary malignancy requiring treatment or limiting survival to =< 2 years
• Any radiation therapy =< 4 weeks prior to registration
• Any major surgery =< 4 weeks prior to registration
• Current use of corticosteroids; EXCEPTION: low doses of steroids (< 10 mg of prednisone or equivalent dose of other steroid) used for treatment of non-hematologic medical conditions; Note: previous use of corticosteroids is allowed
• Active hemolytic anemia requiring immunosuppressive therapy or other pharmacologic treatment; patients who have a positive Coombs test but no evidence of hemolysis are NOT excluded from participation