Combination Chemotherapy Followed by Bone Marrow and/or Peripheral Stem Cell Transplantation in Treating Patients With Recurrent Medulloblastoma or CNS Germ Cell Tumors
Brain Tumor, Central Nervous System Tumor
About this trial
This is an interventional treatment trial for Brain Tumor focused on measuring recurrent childhood brain tumor, childhood central nervous system germ cell tumor, recurrent childhood medulloblastoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of recurrent medulloblastoma or CNS germ cell tumor Histologic review of the primary intracranial or spinal cord tumor required Biopsy and reduction of tumor bulk prior to study encouraged but not required No more than 1 prior primary therapy (radiotherapy or chemoradiotherapy) and/or 1 prior salvage therapy Patients with progression on salvage therapy ineligible Minimal residual disease (tumor bulk no more than 1.5 cm) or in second clinical complete remission (CR) Bone marrow infiltration with or without mass lesions or isolated abnormal CSF cytology as the only manifestation of recurrent disease allowed if a clinical CR is first achieved with conventional therapy PATIENT CHARACTERISTICS: Age: 2 to 25 Performance status: Karnofsky 80-100% Life expectancy: More than 8 weeks Hematopoietic: Absolute neutrophil count greater than 1,000/mm^3 Platelet count greater than 100,000/mm^3 Hepatic: Bilirubin less than 1.5 mg/dL SGPT less than 80 IU Renal: Creatinine less than 1.2 mg/dL Cardiovascular: LVEF normal Other: No infection Able to tolerate vigorous hydration Not pregnant Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: See Disease Characteristics Prior cyclophosphamide or ifosfamide allowed Endocrine therapy: No concurrent dexamethasone as an antiemetic Other concurrent corticosteroids allowed Radiotherapy: See Disease Characteristics Pretransplantation radiotherapy boost allowed Surgery: See Disease Characteristics Pretransplantation surgery allowed Other: At least 4 weeks since prior therapy except corticosteroids
Sites / Locations
- University of Alabama at Birmingham Comprehensive Cancer Center
- University of South Alabama Medical Center
- Arizona Cancer Center
- University of Arkansas for Medical Sciences
- Rebecca and John Moores UCSD Cancer Center
- Sutter Cancer Center
- University of California Davis Cancer Center
- Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego
- Children's Hospital San Diego
- Kaiser Permanente Medical Center - Santa Clara
- Stanford University Medical Center
- Yale Comprehensive Cancer Center
- Walter Reed Army Medical Center
- Broward General Medical Center
- Children's Hospital of Southwest Florida
- Shands Hospital and Clinics, University of Florida
- Joe DiMaggio Children's Hospital at Memorial
- Nemours Children's Clinic
- Sylvester Cancer Center, University of Miami
- Miami Children's Hospital
- Baptist Hospital of Miami
- Florida Hospital Cancer Institute
- Nemours Children's Clinic-Orlando
- Sacred Heart Children's Hospital
- All Children's Hospital
- Tampa Children's Hospital
- St. Mary's Hospital
- Children's Healthcare of Atlanta - Scottish Rite
- Cancer Research Center of Hawaii
- Tripler Army Medical Center
- Rush-Presbyterian-St. Luke's Medical Center
- Children's Memorial Hospital - Chicago
- Advocate Hope Children's Hospital
- Saint Jude Midwest Affiliate
- University of Kansas Medical Center
- CCOP - Wichita
- Via Christi Regional Medical Center
- Wesley Medical Center
- MBCCOP - LSU Health Sciences Center
- Tulane University School of Medicine
- Children's Hospital of New Orleans
- Ochsner Clinic Foundation
- Eastern Maine Medical Center
- Maine Children's Cancer Program
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- Floating Hospital for Children
- Massachusetts General Hospital Cancer Center
- Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
- University of Massachusetts Memorial Medical Center - University Campus
- Children's Hospital of Michigan
- St. John Hospital and Medical Center
- Hurley Medical Center
- University of Mississippi Medical Center
- Keesler Medical Center - Keesler AFB
- University of Missouri-Columbia Hospital and Clinics
- Cardinal Glennon Children's Hospital
- Washington University Medical Center
- Norris Cotton Cancer Center
- Hackensack University Medical Center
- University of New Mexico Cancer Research and Treatment Center
- Roswell Park Cancer Institute
- Schneider Children's Hospital
- Mount Sinai School of Medicine
- Beth Israel Hospital North
- James P. Wilmot Cancer Center
- State University of New York Health Sciences Center - Stony Brook
- State University of New York - Upstate Medical University
- Mission St. Joseph's Health System
- Carolinas Medical Center
- Presbyterian Healthcare
- Duke Comprehensive Cancer Center
- East Carolina University School of Medicine
- Comprehensive Cancer Center at Wake Forest University
- University of Oklahoma Health Sciences Center
- Warren Clinic
- Legacy Emanuel Hospital and Health Center
- St. Christopher's Hospital for Children
- Rhode Island Hospital
- Medical University of South Carolina
- Children's Hospital of Greenville Hospital System
- East Tennessee State University Cancer Center at JCMC
- St. Jude Children's Research Hospital
- Driscoll Children's Hospital
- Medical City Dallas Hospital
- Simmons Cancer Center - Dallas
- Cook Children's Medical Center - Fort Worth
- University of Texas Medical Branch
- Texas Children's Cancer Center
- San Antonio Military Pediatric Cancer and Blood Disorders Center
- University of Texas Health Science Center at San Antonio
- Scott and White Memorial Hospital
- Vermont Cancer Center
- Cancer Center at the University of Virginia
- Inova Fairfax Hospital
- Naval Medical Center, Portsmouth
- Massey Cancer Center
- Carilion Medical Center for Children
- Madigan Army Medical Center
- West Virginia University - Charleston
- West Virginia University Hospitals
- St. Vincent Hospital
- Midwest Children's Cancer Center
- Children's Hospital at Westmead
- Royal Children's Hospital
- Royal Children's Hospital
- Alberta Children's Hospital
- Cross Cancer Institute
- Chedoke-McMaster Hospitals
- Children's Hospital of Eastern Ontario
- Hospital for Sick Children
- McGill University Health Center - Montreal Children's Hospital
- Hopital Sainte Justine
- Centre de Recherche du Centre Hospitalier de l'Universite Laval
- Academisch Ziekenhuis Groningen
- San Jorge Childrens Hospital
- Swiss Pediatric Oncology Group Bern
- Swiss Pediatric Oncology Group Geneva
Arms of the Study
Arm 1
Experimental
Ablative chemo followed by autologous bone marrow (ABM) rescue
Autologous bone marrow and/or peripheral blood stem cells (PBSC) are harvested. Patients then receive intensive cyclophosphamide IV over 1 hour on days -8 to -5 and melphalan IV over 15 minutes on days -4 to -2. Bone marrow is reinfused on day 0. PBSC are reinfused on day 0 if used alone or on day 1 if used after autologous bone marrow transplantation (ABMT). Sargramostim (GM-CSF) is administered IV over 2 hours daily beginning 4 hours after ABMT and continuing until blood counts recover.