Gemcitabine and Vinorelbine in Treating Young Patients With Recurrent or Refractory 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 Hodgkin's lymphoma* with any of the following histologies: Not otherwise specified (NOS) Mixed cellularity NOS Lymphocytic depletion NOS Diffuse fibrosis Reticular Lymphocytic predominance NOS Diffuse Nodular Paragranuloma Granuloma Sarcoma Nodular sclerosis Cellular phase NOS Lymphocytic predominance Mixed cellularity Lymphocytic depletion NOTE: *Disease metastatic to bone marrow with granulocytopenia and/or thrombocytopenia is allowed, but is not evaluable for hematological toxicity Measurable disease by clinical or radiographic criteria Relapsed or refractory to conventional therapy Received at least 2 prior cytotoxic chemotherapy regimens No stage IA or IIA nodal disease previously treated with any of the following: Radiotherapy only No more than 4 courses of prior chemotherapy PATIENT CHARACTERISTICS: Age 30 and under Performance status Karnofsky 50-100% (over 16 years of age) Lansky 50-100% (16 and under) OR ECOG 0-2 Life expectancy At least 8 weeks Hematopoietic See Disease Characteristics Absolute neutrophil count ≥ 750/mm^3 Platelet count ≥ 75,000/mm^3 (transfusion independent, defined as ≥ 3 days since prior platelet transfusion) Hepatic Bilirubin ≤ 1.5 times upper limit of normal (ULN) ALT ≤ 2.5 times ULN Renal Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR Creatinine based on age as follows: No greater than 0.8 mg/dL (age 5 and under) No greater than 1.0 mg/dL (age 6 to 10) No greater than 1.2 mg/dL (age 11 to 15) No greater than 1.5 mg/dL (over age 15) Pulmonary DLCO ≥ 50% FEV_1 ≥ 50% Vital capacity ≥ 50% No evidence of dyspnea at rest No exercise intolerance Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 3 months after study participation Seizure disorder allowed provided patient is on anticonvulsants and disorder is well controlled No evidence of active graft-versus-host disease PRIOR CONCURRENT THERAPY: Biologic therapy Recovered from prior immunotherapy At least 6 months since prior allogeneic stem cell transplantation (SCT) At least 7 days since prior biologic agents More than 3 months since prior autologous SCT More than 1 week since prior growth factors No concurrent immunomodulating agents Chemotherapy See Disease Characteristics More than 2 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosoureas) and recovered No prior gemcitabine and vinorelbine in combination (i.e., administered within 1 week of each other) Prior gemcitabine or vinorelbine administered alone is allowed No other concurrent chemotherapy Endocrine therapy No concurrent steroids, including corticosteroids as an antiemetic or for control of graft-versus-host disease Concurrent corticosteroids allowed only for the following indications: Adrenal crisis in patients with suppressed pituitary/adrenal response Noncardiogenic pulmonary edema Allergic reactions to amphotericin or transfusions treated with low-dose hydrocortisone (less than 100 mg/m^2) Radiotherapy See Disease Characteristics At least 3 weeks since prior radiotherapy and recovered Surgery Not specified Other Concurrent immunosuppressive drugs allowed
Sites / Locations
- Lurleen Wallace Comprehensive Cancer at University of Alabama-Birmingham
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
- Southern California Permanente Medical Group
- Loma Linda University Cancer Institute at Loma Linda University Medical Center
- Jonsson Comprehensive Cancer Center at UCLA
- Children's Hospital Central California
- Kaiser Permanente Medical Center - Oakland
- Children's Hospital and Health Center - San Diego
- UCSF Comprehensive Cancer Center
- Stanford Comprehensive Cancer Center - Stanford
- 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
- Lee Cancer Care of Lee Memorial Health System
- University of Florida Shands Cancer Center
- Nemours Children's Clinic
- University of Miami Sylvester Comprehensive Cancer Center
- Miami Children's Hospital
- Florida Hospital Cancer Institute at Florida Hospital Orlando
- Nemours Children's Clinic - 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
- Winship Cancer Institute of Emory University
- Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
- Cancer Research Center of Hawaii
- Children's Memorial Hospital - Chicago
- 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
- 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
- Floating Hospital for Children at Tufts - New England Medical Center
- Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
- UMASS Memorial Cancer Center - University Campus
- C.S. Mott Children's Hospital at University of Michigan Medical Center
- Barbara Ann Karmanos Cancer Institute
- Hurley Medical Center
- Spectrum Health Hospital - Butterworth Campus
- Van Elslander Cancer Center at St. John Hospital and Medical Center
- Breslin Cancer Center at Ingham Regional Medical Center
- Children's Hospitals and Clinics of Minneapolis
- University of Minnesota Medical Center & Children's Hospital - Fairview
- University of Mississippi Medical Center
- Children's Mercy Hospital
- Siteman Cancer Center at Barnes-Jewish Hospital
- Hackensack University Medical Center Cancer Center
- St. Barnabas Medical Center Cancer Center
- Overlook Hospital
- Newark Beth Israel Medical Center
- University of New Mexico Cancer Research and Treatment Center
- Albany Medical Center Hospital
- Albert Einstein Cancer Center at Albert Einstein College of Medicine
- Brooklyn Hospital Center
- Roswell Park Cancer Institute
- Herbert Irving Comprehensive Cancer Center at Columbia University
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- SUNY Upstate Medical University Hospital
- New York Medical College
- Blumenthal Cancer Center at Carolinas Medical Center
- Presbyterian Cancer Center at Presbyterian Hospital
- Duke Comprehensive Cancer Center
- 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
- Tod Children's Hospital
- Oklahoma University Cancer Institute
- Legacy Emanuel Hospital and Health Center & Children's Hospital
- Geisinger Medical Center
- Penn State Cancer Institute at Milton S. Hershey Medical Center
- Children's Hospital of Philadelphia
- St. Christopher's Hospital for Children
- Children's Hospital of Pittsburgh
- Rhode Island Hospital Comprehensive Cancer Center
- Greenville Hospital System Cancer Center
- Sioux Valley Hospital and University of South Dakota Medical Center
- T.C. Thompson Children's Hospital
- East Tennessee Children's Hospital
- St. Jude Children's Research Hospital
- Vanderbilt-Ingram Cancer Center
- Texas Tech University Health Sciences Center School of Medicine - Amarillo
- Driscoll Children's Hospital
- Medical City Dallas Hospital
- Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
- 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
- Methodist Children's Hospital of South Texas
- CCOP - Scott and White Hospital
- Primary Children's Medical Center
- Children's Hospital of The King's Daughters
- Providence Cancer Center at Sacred Heart Medical Center
- Mary Bridge Children's Hospital and Health Center - Tacoma
- Madigan Army Medical Center - Tacoma
- West Virginia University - Robert C. Byrd Health Sciences Center - Charleston Division
- St. Vincent Hospital Regional Cancer Center
- Marshfield Clinic - Marshfield Center
- Midwest Children's Cancer Center
- Princess Margaret Hospital for Children
- University of Alberta Hospital
- CHUS-Hopital Fleurimont
- Children's & Women's Hospital of British Columbia
- CancerCare Manitoba
- IWK Health Centre
- McMaster Children's Hospital at Hamilton Health Sciences
- Children's Hospital of Eastern Ontario
- Hospital for Sick Children
- Montreal Children's Hospital at McGill University Health Center
- Hopital Sainte Justine
- Saskatoon Cancer Centre at the University of Saskatchewan
- Centre Hospitalier Universitaire de Quebec
- San Jorge Children's Hospital
- Swiss Pediatric Oncology Group Geneva
Arms of the Study
Arm 1
Experimental
Treatment
Patients receive vinorelbine tartrate IV over 6-10 minutes and gemcitabine hydrochloride IV over 100 minutes on days 1 and 8. Patients also receive filgrastim (G-CSF) subcutaneously daily beginning on day 9 and continuing for at least 7 days and until blood counts recover. Treatment repeats every 21 days for at least 2 courses in the absence of disease progression or unacceptable toxicity. Patients with responding disease after 2 courses may proceed directly to stem cell transplantation off study OR receive 2 additional courses. Patients with stable disease after 2 courses receive at least 2 additional courses. Patients with continued stable or responding disease (with no disease progression) after 4 courses may continue to receive study treatment for up to 1 year or discontinue study for alternative therapy at the discretion of the treating physician.