Chemotherapy Plus Peripheral Stem Cell Transplantation in Treating Infants With Malignant Brain or Spinal Cord Tumors
Brain Tumors, Central Nervous System Tumors, Neuroblastoma
About this trial
This is an interventional treatment trial for Brain Tumors focused on measuring childhood infratentorial ependymoma, childhood supratentorial ependymoma, disseminated neuroblastoma, stage 4S neuroblastoma, embryonal childhood rhabdomyosarcoma, childhood high-grade cerebral astrocytoma, childhood choroid plexus tumor, previously untreated childhood rhabdomyosarcoma, untreated childhood brain stem glioma, untreated childhood supratentorial primitive neuroectodermal tumor, untreated childhood cerebellar astrocytoma, untreated childhood medulloblastoma, newly diagnosed childhood ependymoma, localized resectable neuroblastoma, localized unresectable neuroblastoma, regional neuroblastoma, childhood spinal cord neoplasm, childhood atypical teratoid/rhabdoid tumor, childhood low-grade cerebral astrocytoma, childhood central nervous system choriocarcinoma, childhood central nervous system embryonal tumor, childhood central nervous system germinoma, childhood central nervous system mixed germ cell tumor, childhood central nervous system teratoma, childhood central nervous system yolk sac tumor
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically proven malignant brain or spinal cord tumor, including the following: Primitive neuroectodermal tumor Ganglioneuroblastoma Medulloblastoma neuroblastoma Desmoplastic medulloblastoma Medulloepithelioma Ependymoma neuroepithelioma Anaplastic ependymoma germ cell tumor Astrocytoma germinoma Anaplastic astrocytoma Embryonal carcinoma Glioblastoma endodermal sinus tumor Gliosarcoma malignant teratoma Choroid plexus carcinoma Mixed germ cell tumor Cerebellar sarcoma Pineoblastoma Atypical teratoid/rhabdoid tumor Choriocarcinoma Teratoma (malignant or with malignant transformations) Diffusely involved brain stem tumors allowed if there is evidence of brain stem glioma by CT scan or MRI PATIENT CHARACTERISTICS: Age: 6 months to less than 3 years Performance Status: Not specified 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 2.0 mg/dL Renal: Glomerular filtration rate or creatinine clearance greater than 70 mL/min PRIOR CONCURRENT THERAPY: Biologic therapy: No prior biologic therapy Chemotherapy: No prior chemotherapy Endocrine therapy: Prior corticosteroids allowed Radiotherapy: No prior radiotherapy Surgery: No more than 6 weeks since prior surgery Recovered from prior surgery (stable)
Sites / Locations
- City of Hope Comprehensive Cancer Center
- Childrens Hospital Los Angeles
- Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center
- Jonsson Comprehensive Cancer Center at UCLA
- Children's Hospital Central California
- Children's Hospital and Research Center Oakland
- Children's Hospital of Orange County
- Kaiser Permanente Medical Center - Oakland
- UCSF Helen Diller Family Comprehensive Cancer Center
- Children's Hospital Center for Cancer and Blood Disorders
- Presbyterian - St. Luke's Medical Center
- Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center
- Alfred I. duPont Hospital for Children
- Lombardi Comprehensive Cancer Center at Georgetown University Medical Center
- Children's National Medical Center
- AFLAC Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta - Egleston Campus
- MBCCOP - Medical College of Georgia Cancer Center
- Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
- University of Chicago Cancer Research Center
- Indiana University Melvin and Bren Simon Cancer Center
- Holden Comprehensive Cancer Center at University of Iowa
- Lucille P. Markey Cancer Center at University of Kentucky
- Kosair Children's Hospital
- C.S. Mott Children's Hospital at University of Michigan Medical Center
- Butterworth Hospital at Spectrum Health
- CCOP - Kalamazoo
- Children's Hospitals and Clinics of Minnesota - Minneapolis
- Masonic Cancer Center at University of Minnesota
- Mayo Clinic Cancer Center
- Children's Hospitals and Clinics of Minnesota - St. Paul
- Children's Mercy Hospital
- CCOP - Nevada Cancer Research Foundation
- Carol G. Simon Cancer Center at Morristown Memorial Hospital
- Overlook Hospital
- St. Joseph's Hospital and Medical Center
- Albert Einstein Cancer Center at Albert Einstein College of Medicine
- Winthrop University Hospital
- Beth Israel Medical Center - Petrie Division
- NYU Cancer Institute at New York University Medical Center
- Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
- Memorial Sloan-Kettering Cancer Center
- Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
- CCOP - MeritCare Hospital
- Akron Children's Hospital
- Cincinnati Children's Hospital Medical Center
- Rainbow Babies and Children's Hospital
- Cleveland Clinic Taussig Cancer Center
- Nationwide Children's Hospital
- Dayton Children's - Dayton
- Medical University of Ohio Cancer Center
- Knight Cancer Institute at Oregon Health and Science University
- Penn State Children's Hospital
- Children's Hospital of Philadelphia
- Children's Hospital of Pittsburgh of UPMC
- Avera Cancer Institute
- Sanford Cancer Center at Sanford USD Medical Center
- Texas Tech University Health Sciences Center School of Medicine - Amarillo
- Cook Children's Medical Center - Fort Worth
- Covenant Children's Hospital
- Methodist Children's Hospital of South Texas
- Primary Children's Medical Center
- Children's Hospital of The King's Daughters
- Children's Hospital and Regional Medical Center - Seattle
- Group Health Central Hospital
- Deaconess Medical Center
- Mary Bridge Children's Hospital and Health Center - Tacoma
- Princess Margaret Hospital for Children
- Children's & Women's Hospital of British Columbia
- CancerCare Manitoba
- Hospital for Sick Children
- Allan Blair Cancer Centre at Pasqua Hospital
Arms of the Study
Arm 1
Experimental
Treatment (combination chemotherapy, PBSC transplant)
Pts undergo conventional surgery for diagnosis & max tumor resection. In 6 wks of surgery or when stable pts begin induction chemotherapy(cisplatin IV over 6 hrs on day 0; vincristine sulfate IV on days 0,7,14; cyclophosphamide IV over 1 hr on days 1-2; and etoposide IV over 1 hr on days 0-2. 24 hrs after the last cyclophosphamide dose, pts receive filgrastim (G-CSF) & undergo peripheral blood stem cell harvest 2 days later. Treatment repeats every 21 days for up to 3 crs. Within 6 wks after induction, pts receive consolidation (carboplatin IV over 2 hrs on days 0-1 next esc. doses of thiotepa IV over 2 hrs. Pts undergo peripheral blood stem cell transplantation 48 hrs after last thiotepa dose. Pts receive G-CSF SC daily on days 3-21. Treatment repeats every 21 days for up to 3 crs. Pts with dose-limiting toxicity due to thiotepa are removed from study. Pts are followed at 4 wks, 3 mths for 1 yr, 6 mths for 3 yrs, annually for 3 yrs or until relapse.