Cyclophosphamide, Alvocidib, and Rituximab in Treating Patients With High Risk B-Cell Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

You may be eligible if

• Histologically confirmed chronic lymphocytic leukemia (CLL) or B-cell prolymphocytic leukemia\* (PLL) arising from CLL
• * Patients must have documented B-cell lymphocytosis \> 5 x 10\^9/L at some point since initial diagnosis of CLL
• * Patients must have B-cells that co-express CD5 with CD19 or CD20
• * Patients who do not have dim sIg or CD23 expression on their leukemia cells should be examined for cyclin D1 over-expression or t(11;14) to rule out mantle cell lymphoma
• To be considered high risk, patients must meet the following criteria:
• * At least 1 of the following:
• * 17p deletion
• * 11q deletion
• * Un-mutated IgV\_H (≥ 98% homology)
• * Age \> 70 years
• * B\_2M \> 4
• * AND at least 1 of the following:
• * Progressive or marked splenomegaly and/or lymphadenopathy
• * Anemia (hemoglobin \< 11 g/dL) or thrombocytopenia (platelets \< 100,000/mm\^3)
• * Weight loss exceeding 10% of body weight over preceding 6 months
• * NCI grade 2 or 3 fatigue
• * Fevers \> 100.5° F or night sweats for \> 2 weeks without evidence of infection
• * Progressive lymphocytosis, with an increase exceeding 50% over a 2-month period or a doubling time of \< 6 months
• No other concurrent hormones, chemotherapy, or radiotherapy except for steroids for new adrenal failure or hormones for nondisease-related conditions (e.g., insulin for diabetes)
• * No requirement for chronic corticosteroids
• ECOG performance status 0-2
• Creatinine ≤ 2.0 mg/dL
• Bilirubin ≤ 1.5 times normal unless due to Gilbert disease, hemolysis, or disease infiltration of the liver
• AST ≤ 2 times normal unless due to hemolysis or disease infiltration of the liver
• Negative pregnancy test
• Not pregnant or nursing
• Fertile patients must use effective contraception
• No secondary or other malignancy that will limit survival to \< 2 years
• No uncontrolled concurrent illness including, but not limited to, any of the following:
• * Ongoing or active infection
• * Symptomatic congestive heart failure
• * Unstable angina pectoris
• * Cardiac arrhythmia
• * Psychiatric illness or social situations that would limit compliance with study requirements
• No uncompensated HIV without adequate CD4 (\> 200/mm\^3) and requiring HIV medication
• No active hepatitis B infection
• No known G6PD deficiency
• No history of allergic reactions attributed to compounds of similar chemical or biologic composition to alvocidib, cyclophosphamide, rituximab, or other agents used in this study
• No prior alvocidib
• No prior purine analog therapy
• No more than 1 prior treatment with a biologic or alkylating agent
• No other concurrent investigational agents