Immunotherapy Using Cyclosporine, Interferon Gamma, and Interleukin-2 After High-Dose Myeloablative Chemotherapy With Autologous Stem Cell Transplantation in Treating Patients With Refractory or Relapsed Hodgkin's Lymphoma
Lymphoma
About this trial
This is an interventional treatment trial for Lymphoma focused on measuring recurrent adult Hodgkin lymphoma, recurrent/refractory childhood Hodgkin lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of Hodgkin's lymphoma Histologically confirmed at original diagnosis AND at relapse or disease progression Relapsed or refractory to conventional therapy No recurrence without B symptoms or bulky disease at least 1 year after completion of minimal systemic therapy defined by either of the following: Stage IA/IIA with nodal disease previously treated with radiotherapy only Stage IA/IIA with nodal disease previously treated with less than 3 courses of standard dose chemotherapy Concurrently enrolled on the COG-AHOD00P1 salvage chemotherapy study OR received other appropriate salvage therapy (e.g., ifosfamide and vinorelbine) PATIENT CHARACTERISTICS: Age Under 30 Performance status ECOG 0-2 (for adults) Lansky 50-100% (for children) Life expectancy At least 2 months Hematopoietic Absolute neutrophil count at least 500/mm^3 Hepatic Bilirubin no greater than 1.5 times normal SGPT less than 2.5 times normal Renal Creatinine no greater than 1.5 times normal OR Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min/1.73 m^2 Cardiovascular Shortening fraction at least 27% by echocardiogram OR Ejection fraction at least 50% by MUGA Pulmonary No evidence of dyspnea at rest No exercise intolerance DLCO at least 50% (patients 8 years of age and over) Other Not pregnant or nursing Negative pregnancy test No concurrent serious illness PRIOR CONCURRENT THERAPY: Biologic therapy Recovered from prior immunotherapy At least 1 week since prior antineoplastic biologic agents More than 1 week since prior growth factors No prior stem cell transplantation No other concurrent immunomodulating agents Chemotherapy See Disease Characteristics More than 2 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosoureas) and recovered No other concurrent anticancer chemotherapy Endocrine therapy No concurrent steroids, including dexamethasone as an antiemetic Radiotherapy See Disease Characteristics Recovered from prior radiotherapy Surgery Not specified Other No concurrent participation in another COG therapeutic study
Sites / Locations
- Comprehensive Cancer Center at University of Alabama at Birmingham
- Phoenix Children's Hospital
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
- Jonsson Comprehensive Cancer Center at UCLA
- Children's Hospital and Research Center - Oakland
- Children's Hospital of Orange County
- Kaiser Permanente Medical Center - Oakland
- Alfred I. duPont Hospital for Children
- Children's National Medical Center
- University of Florida Shands Cancer Center
- Nemours Children's Clinic
- University of Miami Sylvester Comprehensive Cancer Center
- Miami Children's Hospital
- All Children's Hospital
- St. Joseph's Cancer Institute at St. Joseph's Hospital
- Kaplan Cancer Center at St. Mary's Medical Center
- Emory University Hospital - Atlanta
- Children's Memorial Hospital - Chicago
- Southern Illinois University School of Medicine
- Indiana University Cancer Center
- St. Vincent Indianapolis Hospital
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
- Kosair Children's Hospital
- Children's Hospital of New Orleans
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- Massachusetts General Hospital Cancer Center
- C.S. Mott Children's Hospital at University of Michigan
- Barbara Ann Karmanos Cancer Institute
- Hurley Medical Center
- Spectrum Health Cancer Care - Butterworth Campus
- Van Elslander Cancer Center at St. John Hospital and Medical Center
- Children's Hospital of Minnesota - Minneapolis
- Fairview University Medical Center - University Campus
- Mayo Clinic Cancer Center
- University of Mississippi Medical Center
- Children's Mercy Hospital
- Hackensack University Medical Center Cancer Center
- Roswell Park Cancer Institute
- Mount Sinai Medical Center
- Long Island Cancer Center at Stony Brook University Hospital
- SUNY Upstate Medical University Hospital
- New York Medical College
- Cincinnati Children's Hospital Medical Center
- Rainbow Babies and Children's Hospital
- Children's Medical Center - Dayton
- Penn State Cancer Institute at Milton S. Hershey Medical Center
- Children's Hospital of Pittsburgh
- Hollings Cancer Center at Medical University of South Carolina
- St. Jude Children's Research Hospital
- Texas Tech University Health Sciences Center School of Medicine
- Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
- Cook Children's Medical Center - Fort Worth
- Covenant Children's Hospital
- University of Texas Health Science Center at San Antonio
- Methodist Children's Hospital of South Texas
- CCOP - Scott and White Hospital
- Children's Hospital of the King's Daughters
- St. Vincent Hospital Regional Cancer Center
- Marshfield Clinic - Marshfield Center
- Midwest Children's Cancer Center
- Princess Margaret Hospital for Children
- Hopital Sainte Justine
- Saskatoon Cancer Centre at the University of Saskatchewan
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Hyperfractionated Involved-Field Radiotion-immunotherapy
Hyperfractionated Involved-Field Radiotion-no immunotherapy
Completed prior salvage induction therapy and have not received full tissue tolerance from prior radiotherapy may receive hyperfractionated involved-field radiotherapy twice daily for 7 days. HIGH-DOSE PREPARATIVE REGIMEN: Beginning within 7 days after radiotherapy, carmustine IV over 3 hours on day -6; etoposide IV over 1 hour and cytarabine IV over 1 hour on days -5 to -2; and melphalan IV over 30 minutes on day -1. ASCT: Autologous bone marrow or peripheral blood stem cell transplantation on day 0. Filgrastim (oral or IV) beginning on day 1 and continuing until blood counts recover. IMMUNOTHERAPY: Cyclosporine IV twice daily beginning on day 0 and continuing until the completion of the course of recombinant interferon gamma and interleukin-2. When sufficiently recovered, Aldesleukin once daily for 18 days.
Completed prior salvage induction therapy and have not received full tissue tolerance from prior radiotherapy may receive hyperfractionated involved-field radiotherapy twice daily for 7 days. HIGH-DOSE PREPARATIVE REGIMEN: Beginning within 7 days after radiotherapy, carmustine IV over 3 hours on day -6; etoposide IV over 1 hour and cytarabine IV over 1 hour on days -5 to -2; and melphalan IV over 30 minutes on day -1. ASCT: Autologous bone marrow or peripheral blood stem cell transplantation on day 0. Filgrastim (oral or IV) beginning on day 1 and continuing until blood counts recover.