Umbilical Cord Blood for Stem Cell Transplantation in Treating Young Patients With Malignant or Nonmalignant Diseases
Childhood Langerhans Cell Histiocytosis, Fanconi Anemia, Leukemia
About this trial
This is an interventional treatment trial for Childhood Langerhans Cell Histiocytosis focused on measuring childhood myelodysplastic syndromes, recurrent childhood rhabdomyosarcoma, unspecified childhood solid tumor, protocol specific, previously treated childhood rhabdomyosarcoma, previously untreated childhood rhabdomyosarcoma, disseminated neuroblastoma, regional neuroblastoma, recurrent neuroblastoma, metastatic Ewing sarcoma/peripheral primitive neuroectodermal tumor, recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor, recurrent childhood acute lymphoblastic leukemia, juvenile myelomonocytic leukemia, childhood acute lymphoblastic leukemia in remission, childhood Burkitt lymphoma, recurrent childhood lymphoblastic lymphoma, stage III childhood lymphoblastic lymphoma, stage IV childhood lymphoblastic lymphoma, recurrent childhood small noncleaved cell lymphoma, stage III childhood small noncleaved cell lymphoma, stage IV childhood small noncleaved cell lymphoma, recurrent childhood large cell lymphoma, stage III childhood large cell lymphoma, stage IV childhood large cell lymphoma, stage III childhood Hodgkin lymphoma, stage IV childhood Hodgkin lymphoma, previously treated myelodysplastic syndromes, Fanconi anemia, de novo myelodysplastic syndromes, secondary myelodysplastic syndromes, childhood chronic myelogenous leukemia, chronic phase chronic myelogenous leukemia, relapsing chronic myelogenous leukemia, childhood Langerhans cell histiocytosis, recurrent childhood acute myeloid leukemia, recurrent/refractory childhood Hodgkin lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of malignant or non-malignant disease, including but not limited to any of the following: Acute myeloid leukemia or acute lymphoblastic leukemia (ALL) with resistant disease beyond first clinical remission (CR) ALL in first CR at high-risk because of 1 of the following factors: Hypoploidy Pseudodiploidy with translocations t(9;22), t(4;11), or t(8;14) Elevated WBC at diagnosis as follows: > 100,000/mm^3 for patients 6-12 months of age > 50,000/mm^3 for patients 10-20 years of age > 20,000/mm^3 for patients 21 years of age Burkitt's lymphoma/leukemia Chronic myelogenous leukemia in first chronic phase or beyond Juvenile myelomonocytic leukemia Advanced stage or relapsed lymphoma Advanced stage or relapsed solid tumors, including any of the following: Neuroblastoma Ewing's sarcoma Rhabdomyosarcoma Myelodysplastic syndromes, excluding patients with grade 3 or 4 myelofibrosis Familial erythrophagocytic histiocytosis Histiocytosis unresponsive to medical management Inborn errors of metabolism Langerhans cell histiocytosis unresponsive to medical management Immune deficiencies, including: Severe combined immune deficiency Wiskott-Aldrich Hemoglobinopathies, including sickle cell disease and thalassemia Severe aplastic anemia Fanconi's anemia Metabolic storage diseases Unrelated cord blood donor must be HLA-identical OR may be mismatched for 1, 2, or 3 HLA-loci (A, B, DR) No other existing HLA-identical related donor available at the time of transplantation PATIENT CHARACTERISTICS: Age 21 and under Performance status Not specified Life expectancy Not specified Hematopoietic See Disease Characteristics Hepatic Not specified Renal Not specified PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy Not specified Endocrine therapy Not specified Radiotherapy Not specified Surgery Not specified
Sites / Locations
- Penn State Hershey Cancer Institute at Milton S. Hershey Medical CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Experimental
Regimen A
Regimen B (patients who do not receive TBI)
Regimen C (patients with Fanconi's anemia/related disorders)
Regimen D
Patients undergo total body irradiation (TBI) two times daily on days -7 to -4. Patients receive cyclophosphamide IV over 30-60 minutes on days -3 and -2 and anti-thymocyte globulin (ATG) IV over at least 6 hours on days -3 to -1.
Patients receive oral busulfan 4 times daily on days -8 to -5, and ATG IV over at least 6 hours and melphalan IV over 15-20 minutes on days -4 to -2.
Patients undergo TBI on day -6. Patients receive ATG IV over at least 6 hours and methylprednisolone IV on days -5 to -1 and fludarabine IV over 30 minutes and cyclophosphamide IV over 30-60 minutes on days -5 to -2.
Patients receive oral or IV busulfan 4 times daily on days -9 to -5, ATG IV over at least 6 hours on days -5 to -3, and cyclophosphamide IV over 30-60 minutes on days -5 to -2.