Combination Chemotherapy in Treating Children With Refractory or Relapsed Hodgkin's Lymphoma
Lymphoma
About this trial
This is an interventional treatment trial for Lymphoma focused on measuring recurrent/refractory childhood Hodgkin lymphoma, childhood lymphocyte predominant Hodgkin lymphoma, childhood lymphocyte depletion Hodgkin lymphoma, childhood nodular sclerosis Hodgkin lymphoma, childhood mixed cellularity Hodgkin lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed refractory or relapsed Hodgkin's lymphoma Mixed cellularity, not otherwise specified (NOS) Lymphocytic depletion, NOS Lymphocytic depletion, diffuse fibrosis Lymphocytic depletion, reticular Lymphocytic predominance, NOS Lymphocytic predominance, diffuse Lymphocytic predominance, nodular Hodgkin's paragranuloma NOS Hodgkin's granuloma Hodgkin's sarcoma Nodular sclerosis, NOS Nodular sclerosis, cellular phase Nodular sclerosis, lymphocytic predominance Nodular sclerosis, mixed cellularity Nodular sclerosis, lymphocytic depletion Other (type not specified) In first relapse Metastasis to bone marrow with granulocytopenia, anemia, and/or thrombocytopenia allowed Not enrolled on POG-9426 unless there is an extranodal site of recurrence PATIENT CHARACTERISTICS: Age: Under 30 at diagnosis Performance status: Lansky 60-100% (for patients 16 years and under) Karnofsky 60-100% (for patients over 16 years) Life expectancy: At least 2 months Hematopoietic: See Disease Characteristics Absolute neutrophil count at least 1,000/mm^3 Platelet count at least 75,000/mm^3 (transfusion independent) Hepatic: Bilirubin no greater than 1.5 times normal SGOT or SGPT less than 2.5 times normal Renal: Creatinine no greater than 1.5 times normal Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min Cardiovascular: Shortening fraction at least 27% by echocardiogram OR Ejection fraction at least 50% by gated radionuclide Other: No other concurrent serious illness No known hypersensitivity to E. coli-derived proteins, filgrastim (G-CSF), or any other component of study drugs PRIOR CONCURRENT THERAPY: Biologic therapy: No concurrent immunomodulating agents Chemotherapy: At least 2 weeks since prior chemotherapy (3 weeks for nitrosoureas) and recovered No other concurrent anticancer chemotherapy Endocrine therapy: No concurrent steroids No concurrent corticosteroids (e.g., dexamethasone) Radiotherapy: Recovered from prior radiotherapy Surgery: Not specified
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
- Southern California Permanente Medical Group
- Jonathan Jaques Children's Cancer Center at Miller Children's Hospital
- Jonsson Comprehensive Cancer Center at UCLA
- Children's Hospital Central California
- Children's Hospital of Orange County
- Sutter Cancer Center
- Kaiser Permanente Medical Center - Oakland
- Children's Hospital and Health Center - San Diego
- Stanford Cancer Center at Stanford University Medical Center
- Children's Hospital Cancer 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
- Lee Cancer Care of Lee Memorial Health System
- University of Florida Shands Cancer Center
- Nemours Children's Clinic
- Miami Children's Hospital
- Florida Hospital Cancer Institute at Florida Hospital Orlando
- M.D. Anderson Cancer Center - Orlando
- Sacred Heart Cancer Center at Sacred Heart Hospital
- All Children's Hospital
- St. Joseph's Cancer Institute at St. Joseph's Hospital
- Kaplan Cancer Center at St. Mary's Medical Center
- Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
- Cancer Research Center of Hawaii
- St. Luke's Mountain States Tumor Institute - Boise
- University of Illinois Cancer Center
- Southern Illinois University School of Medicine
- Indiana University Cancer Center
- St. Vincent Indianapolis Hospital
- Blank Children's Hospital
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
- Markey Cancer Center at University of Kentucky Chandler Medical Center
- Kosair Children's Hospital
- Children's Hospital of New Orleans
- CancerCare of Maine at Eastern Maine Medial Center
- Maine Children's Cancer Program
- Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- 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
- CCOP - Kalamazoo
- Children's Hospital of Minnesota - Minneapolis
- Mayo Clinic Cancer Center
- University of Mississippi Medical Center
- Keesler Medical Center - Keesler Air Force Base
- Ellis Fischel Cancer Center at University of Missouri - Columbia
- Children's Mercy Hospital
- Hackensack University Medical Center Cancer Center
- St. Barnabas Medical Center
- Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
- Newark Beth Israel Medical Center
- Albert Einstein Cancer Center at Albert Einstein College of Medicine
- Brooklyn Hospital Center
- Roswell Park Cancer Institute
- NYU Cancer Institute at New York University Medical Center
- Herbert Irving Comprehensive Cancer Center at Columbia University
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- Long Island Cancer Center at Stony Brook University Hospital
- SUNY Upstate Medical University Hospital
- New York Medical College
- Blumenthal Cancer Center at Carolinas Medical Center
- Presbyterian Cancer Center at Presbyterian Hospital
- Children's Hospital Medical Center of Akron
- Cincinnati Children's Hospital Medical Center
- Rainbow Babies and Children's Hospital
- Cleveland Clinic Taussig Cancer Center
- Children's Medical Center - Dayton
- Toledo Hospital
- Oklahoma University Medical Center
- Institute of Oncology at Vilnius University
- Penn State Cancer Institute at Milton S. Hershey Medical Center
- Children's Hospital of Pittsburgh
- Hollings Cancer Center at Medical University of South Carolina
- Greenville Hospital System Cancer Center
- T.C. Thompson Children's Hospital
- Texas Tech University Health Sciences Center School of Medicine
- Medical City Dallas Hospital
- Cook Children's Medical Center - Fort Worth
- Baylor University Medical Center - Houston
- Covenant Children's Hospital
- University of Texas Health Science Center at San Antonio
- CCOP - Scott and White Hospital
- Primary Children's Medical Center
- University of Virginia Cancer Center
- INOVA Fairfax Hospital
- Children's Hospital of the King's Daughters
- Massey Cancer Center at Virginia Commonwealth University
- Carilion Cancer Center of Western Virginia
- Children's Hospital and Regional Medical Center - Seattle
- Madigan Army Medical Center - Tacoma
- Edwards Comprehensive Cancer Center at Cabell Huntington Hospital
- St. Vincent Hospital Regional Cancer Center
- Marshfield Clinic - Marshfield Center
- Midwest Children's Cancer Center
- Prince of Wales Private Hospital
- Westmead Institute for Cancer Research at Westmead Hospital
- Princess Margaret Hospital for Children
- Alberta Children's Hospital
- Children's & Women's Hospital of British Columbia
- IWK Health Centre
- McMaster Children's Hospital at Hamilton Health Sciences
- Hospital for Sick Children
- Montreal Children's Hospital at McGill University Health Center
- Hopital Sainte Justine
- Centre Hospitalier Universitaire de Quebec
- Allan Blair Cancer Centre at Pasqua Hospital
- Saskatoon Cancer Centre at the University of Saskatchewan
Arms of the Study
Arm 1
Experimental
Treatment (ifosfamide, vinorelbine, filgrastim)
Patients receive ifosfamide IV over 24 hours on days 1-4 and vinorelbine tartrate IV over 6-10 minutes on days 1 and 5. Patients also receive filgrastim (G-CSF) subcutaneously or IV over 15-30 minutes beginning 24-36 hours after completion of vinorelbine and continuing daily until blood counts recover. Treatment repeats at least every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. Patients may receive a third course of therapy at the discretion of the investigator. Heavily pretreated, high-risk patients who achieve a complete response are eligible for stem cell transplantation. Patients undergo peripheral blood stem cell (PBSC) collection during hematopoietic recovery after the second course of chemotherapy. Patients with sufficient PBSCs collected may undergo PBSC transplantation on protocol COG-AHOD0121.