A Phase II Study of Epratuzumab in Combination with Cytarabine and Clofarabine for Patients with Relapsed or Refractory Precursor B-cell Acute Lymphoblastic Leukemia

Pts must have refractory or relapsed Ph-negative precursor B cell ALL (any number of prior therapies) with evidence of ALL in marrow or blood. M0 AML, mixed lineage leukemia or Burkitts are not eligible. Pts must have >/= 5% lymphoblasts in blood or marrow and >/= 20% of lymphoblasts must be CD22+ by flow cytometry. Pretreatment cytogenetics must be performed. Pts must be offered participation in MRD testing. Pts must not have active CNS involvement. Pts with previous CNS or evidence of CNS must have lumbar puncture negative for CNS involvement. Pts may have received prior transplant, but must not be receiving immunosuppressive therapy for GvHD. Transplant must have been > 90 days prior to reg and pt must not have >/= Grade 2 GvHD. Pts must not have received chemo, other investigational agent or had major surgery within 14 days prior to reg (except hydroxyurea or maintenance with steroids, vincristine and/or anti-metabolite agents). Drug-related toxicities must have resolved to </= Grade 2. Pts must be >/= 16 yrs of age. Pts must not have received previous clofarabine or epratuzumab treatment. Pts must have Zubrod PS 0-2. Pts must have serum creatinine </= 2 OR estimated glomular filtration rate > 60 ml/min/1.73 m2. Pts must have SGOT and SGPT </= 2.5 x IULN, bilirubin </= 1.5 x IULN and alkaline phosphatase </= 2.5 x IULN. Pts must have triplicate EKG with corrected electrolytes. Study Coordinator must be contacted for QTc > 500 to determine eligibility. Pts must not have systemic, fungal, bacterial, viral or other uncontrolled infection. Pts must not have >/= Grade 2 neuropathy. HIV+ pts must be discussed with and approved by Study Coordinator. Pts must not be pregnant or nursing and must agree to use effective contraception. Prior malignancy other than ALL is allowed but must be in remission with no plan to treat at the time of reg. Pts must be informed of the investigational nature of the study and must sign and give written consent.