Combination Chemotherapy Followed by Peripheral Stem Cell Transplantation in Treating Children With Recurrent or Refractory Hodgkin's or Non-Hodgkin's Lymphoma
Lymphoma
About this trial
This is an interventional treatment trial for Lymphoma focused on measuring recurrent childhood lymphoblastic lymphoma, childhood diffuse large cell lymphoma, childhood immunoblastic large cell lymphoma, recurrent/refractory childhood Hodgkin lymphoma, recurrent childhood small noncleaved cell lymphoma, recurrent childhood large cell lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed non-Hodgkin's lymphoma in first relapse or refractory after primary induction therapy Histologically confirmed Hodgkin's lymphoma in first relapse after chemotherapy with more than one nodal region involved at relapse or refractory after primary induction therapy (i.e., failed to achieve remission at the conclusion of standard induction chemotherapy) No prior radiotherapy only for low stage nodal disease No greater than 4 courses of standard chemotherapy for low stage nodal disease CSF or bone marrow involvement at time of study entry is allowed PATIENT CHARACTERISTICS: Age: 1 to 21 (at initial diagnosis) Performance status: Not specified Life expectancy: Not specified Hematopoietic: Not specified Hepatic: SGOT or SGPT less than 2.5 times normal Bilirubin no greater than 1.5 mg/dL Renal: Creatinine less than 1.5 mg/dL Glomerular filtration rate greater than 60 mL/min as measured by radionuclide scan or 24 hour urine collection for creatinine clearance Cardiovascular: Shortening fraction of at least 28% by echocardiogram Ejection fraction of at least 40% by radionuclide angiogram echocardiogram Pulmonary: Total lung capacity (TLC) at least 50% OR Vital capacity (VC) at least 65% of normal DLCO at least 55% of normal For children who are uncooperative to pulmonary function testing, no dyspnea at rest or with mild exercise, and a pulse oximetry of at least 95% Other: HIV negative PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: See Disease Characteristics Endocrine therapy: Not specified Radiotherapy: See Disease Characteristics Surgery: Not specified
Sites / Locations
- University of Alabama at Birmingham Comprehensive Cancer Center
- University of South Alabama Medical Center
- Phoenix Children's Hospital
- Arizona Cancer Center
- University of Arkansas for Medical Sciences
- Southern California Permanente Medical Group
- City of Hope Comprehensive Cancer Center
- Rebecca and John Moores UCSD Cancer Center
- Loma Linda University Medical Center
- Jonathan Jaques Children's Cancer Center
- Children's Hospital Los Angeles
- Cedars-Sinai Medical Center
- Jonsson Comprehensive Cancer Center, UCLA
- Children's Hospital Central California
- Children's Hospital of Oakland
- Chao Family Comprehensive Cancer Center
- Children's Hospital of Orange County
- Lucile Packard Children's Hospital at Stanford
- Sutter Cancer Center
- University of California Davis Medical Center
- Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego
- Children's Hospital San Diego
- Kaiser Permanente Medical Center - San Francisco Geary Campus
- UCSF Comprehensive Cancer Center
- Santa Barbara Cottage Hospital
- Kaiser Permanente Medical Center - Santa Clara
- David Grant Medical Center
- Children's Hospital of Denver
- Childhood Hematology/Oncology Associates
- Presbyterian-St Luke's Medical Center
- University of Connecticut Health Center
- Yale Comprehensive Cancer Center
- Alfred I. Dupont Institute
- Lombardi Cancer Center
- Children's National Medical 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
- University of Miami-Jackson Memorial Hospital
- 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
- Emory University Hospital - Atlanta
- Children's Healthcare of Atlanta - Scottish Rite
- Medical College of Georgia Comprehensive Cancer Center
- Medical Center of Central Georgia
- Memorial Health University Medical Center, Inc.
- Cancer Research Center of Hawaii
- MBCCOP - Hawaii
- Tripler Army Medical Center
- Mountain States Tumor Institute
- University of Chicago Cancer Research Center
- Rush-Presbyterian-St. Luke's Medical Center
- University of Illinois at Chicago
- Children's Memorial Hospital - Chicago
- Hope Children's Hospital
- Lutheran General Hospital
- Saint Jude Midwest Affiliate
- Southern Illinois University School of Medicine
- Indiana University Cancer Center
- St. Vincent Hospital and Health Care Center
- Raymond Blank Memorial Hospital for Children
- John Stoddard Cancer Center
- Holden Comprehensive Cancer Center
- Wesley Medical Center
- Albert B. Chandler Medical Center, University of Kentucky
- Kosair Children's Hospital
- Tulane University School of Medicine
- Children's Hospital of New Orleans
- Ochsner Clinic
- Eastern Maine Medical Center
- Maine Children's Cancer Program
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland
- Sinai Hospital of Baltimore
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- Floating Hospital for Children
- Dana-Farber Cancer Institute
- Baystate Medical Center
- University of Massachusetts Memorial Medical Center - University Campus
- Mott Children's Hospital
- Children's Hospital of Michigan
- Henry Ford Hospital
- St. John Hospital and Medical Center
- Michigan State University
- Hurley Medical Center
- Spectrum Health and DeVos Children's Hospital
- Bronson Methodist Hospital
- CCOP - Beaumont
- William Beaumont Hospital
- St. Mary's/Duluth Clinic Cancer Center
- Children's Hospitals and Clinics - Minneapolis
- Mayo Clinic Cancer Center
- Children's Hospitals and Clinics of Minnesota
- University of Mississippi Medical Center
- Children's Mercy Hospital
- Cardinal Glennon Children's Hospital
- St. Louis Children's Hospital
- Children's Hospital of Omaha
- University of Nebraska Medical Center
- Sunrise Hospital and Medical Center
- Norris Cotton Cancer Center
- Hackensack University Medical Center
- Cancer Institute of New Jersey
- Newark Beth Israel Medical Center
- St. Joseph's Hospital and Medical Center
- Atlantic Health System
- University of New Mexico Cancer Research and Treatment Center
- Cancer Center of Albany Medical Center
- Albert Einstein Clinical Cancer Center
- Brooklyn Hospital Center
- State University of New York Health Science Center at Brooklyn College of Medicine
- Brookdale University Hospital and Medical Center
- Maimonides Medical Center
- Roswell Park Cancer Institute
- North Shore University Hospital
- Schneider Children's Hospital
- New York Presbyterian Hospital - Cornell Campus
- Memorial Sloan-Kettering Cancer Center
- Mount Sinai School of Medicine
- Columbia Presbyterian Hospital
- James P. Wilmot Cancer Center
- State University of New York Health Sciences Center - Stony Brook
- State University of New York - Upstate Medical University
- New York Medical College
- Mission Saint Joseph's Health System
- Lineberger Comprehensive Cancer Center, UNC
- Carolinas Medical Center
- Presbyterian Healthcare
- Duke Comprehensive Cancer Center
- East Carolina University School of Medicine
- Comprehensive Cancer Center at Wake Forest University
- Dakota Cancer Institute
- Children's Hospital Medical Center of Akron
- Children's Hospital Medical Center - Cincinnati
- Ireland Cancer Center
- Cleveland Clinic Taussig Cancer Center
- Children's Hospital of Columbus
- Children's Medical Center - Dayton
- Toledo Children's Hospital
- St. Vincent Mercy Medical Center
- Forum Health-Tod Childrens Hospital
- Children's Hospital of Oklahoma
- CCOP - Oklahoma
- Natalie Warren Bryant Cancer Center
- Doernbecher Children's Hospital
- Legacy Emanuel Hospital and Health Center
- Geisinger Medical Center
- Milton S. Hershey Medical Center
- Children's Hospital of Philadelphia
- St. Christopher's Hospital for Children
- Children's Hospital of Pittsburgh
- Rhode Island Hospital
- Medical University of South Carolina
- Palmetto Health South Carolina Cancer Center
- Children's Hospital of Greenville Hospital System
- Avera Cancer Institute
- Sioux Valley Hospital
- East Tennessee State University Cancer Center at JCMC
- East Tennessee Children's Hospital
- Saint Jude Children's Research Hospital
- Vanderbilt-Ingram Cancer Center
- Texas Tech University Health Sciences Center School of Medicine
- Children's Hospital of Austin
- Medical City Dallas Hospital
- Simmons Cancer Center - Dallas
- Cook Children's Medical Center - Fort Worth
- University of Texas Medical Branch
- University of Texas - MD Anderson Cancer Center
- Baylor College of Medicine
- San Antonio Military Pediatric Cancer and Blood Disorders Center
- Covenant Children's Hospital
- University of Texas Health Science Center at San Antonio
- Methodist Health Care System
- Scott and White Memorial Hospital
- Huntsman Cancer Institute
- Vermont Cancer Center
- Cancer Center at the University of Virginia
- Inova Fairfax Hospital
- Children's Hospital of the King's Daughters
- Naval Medical Center, Portsmouth
- Massey Cancer Center
- Carilion Medical Center for Children
- Children's Hospital and Regional Medical Center - Seattle
- Fred Hutchinson Cancer Research Center
- Group Health Cooperative
- Deaconess Medical Center
- Mary Bridge Children's Health Center
- Madigan Army Medical Center
- West Virginia University - Charleston
- Cabell-Huntington Hospital, Inc
- West Virginia University Hospitals
- Bellin Memorial Hospital
- CCOP - St. Vincent Hospital Cancer Center, Green Bay
- St. Vincent Hospital
- Gundersen Lutheran Medical Center
- University of Wisconsin Hospital and Clinics
- Marshfield Clinic
- Midwest Children's Cancer Center
- Sydney Children's Hospital
- Children's Hospital at Westmead
- Royal Children's Hospital
- Women's and Children's Hospital
- Royal Children's Hospital
- Princess Margaret Hospital for Children
- Alberta Children's Hospital
- Cross Cancer Institute
- British Columbia Children's Hospital
- CancerCare Manitoba
- Janeway Children's Health and Rehabilitation Centre
- IWK Health Centre
- Children's Hospital
- Children's Hospital of Western Ontario
- Children's Hospital of Eastern Ontario
- Hospital for Sick Children
- McGill University Health Center - Montreal Children's Hospital
- Hopital Sainte Justine
- Centre Hospitalier de L'Universite Laval
- Laval University Medical Center
- Allan Blair Cancer Centre
- Saskatoon Cancer Centre
- Academisch Ziekenhuis Groningen
- Starship Children's Hospital
- University of Puerto Rico School of Medicine Medical Sciences Campus
- San Jorge Childrens Hospital
- Swiss Pediatric Oncology Group Bern
- Swiss Pediatric Oncology Group Geneva
- Swiss Pediatric Oncology Group Lausanne
Arms of the Study
Arm 1
Experimental
Reinduction Therapy
Two courses of reinduction chemotherapy followed by bone marrow biopsy and aspirate prior to peripheral blood stem cell (PBSC) harvest. If marrow involvement is still present at harvest, then 2 additional courses of induction chemotherapy are given. The PBSC transplantation preparative regimen should begin within 2 weeks of completing reinduction therapy course, consisting of the following: Carmustine IV over 3 hours on days -8, -7, and -6, Etoposide continuous IV over days -8, -7, and -6, Cyclophosphamide IV over 1 hour daily on days -5, -4, -3, and -2, Mesna as a 15 min infusion before each dose of cyclophosphamide then at 3, 6, 9, and 12 hours after initiation of each cyclophosphamide dose Methylprednisolone IV is given to protect lungs from the toxic effects of carmustine.