Combination Chemotherapy, Peripheral Stem Cell Transplantation, and Biological Therapy in Treating Patients With Solid Tumors or Lymphoma
Combination Chemotherapy, Peripheral Stem Cell Transplantation, and Biological Therapy in Treating Patients With Solid Tumors or Lymphoma
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so
 they stop growing or die. Combining chemotherapy with peripheral stem cell transplantation
 may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells.
 Biological therapies such as interleukin-2 use different ways to stimulate the immune system
 and stop cancer cells from growing.

 PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy, peripheral
 stem cell transplantation, and interleukin-2 in treating patients who have solid tumors or
 lymphoma.
OBJECTIVES:

 -  Determine the toxicity of sargramostim (GM-CSF) and filgrastim (G-CSF)-mobilized
 interleukin-2(IL-2)-incubated autologous peripheral blood stem cells and sequential IL-2
 in patients with solid tumors or lymphoma.

 -  Determine the ability of cyclophosphamide and paclitaxel followed by GM-CSF and G-CSF to
 mobilize adequate numbers of CD34+ cells and immune cells in these patients.

 -  Determine the time to neutrophil and platelet engraftment in patients treated with this
 regimen.

 -  Determine the overall and disease-free survival of patients treated with this regimen.

 OUTLINE: Patients receive cyclophosphamide IV over 1-2 hours on day 1 and paclitaxel IV over
 4 hours on day 2. Patients also receive sargramostim (GM-CSF) subcutaneously (SC) alone on
 days 3-9 and GM-CSF and filgrastim (G-CSF) SC beginning on day 10 and continuing until
 leukapheresis is completed.

 Patients receive high-dose chemotherapy comprising oral busulfan every 6 hours on days -8 to
 -6, melphalan IV on days -5 and -4, and thiotepa IV on days -3 and -2. Autologous peripheral
 blood stem cells (PBSC) are treated ex vivo with interleukin-2 (IL-2) on day -1. Patients
 undergo IL-2-treated autologous PBSC transplantation on day 0.

 Beginning 4 hours after PBSC transplantation, patients receive IL-2 IV continuously for 5
 days. IL-2 therapy repeats every 7 days for 4 courses.

 Patients are followed on days 60-80, every 6 months for 2 years, and then annually
 thereafter.

 PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study within 3 years.
DISEASE CHARACTERISTICS:

 -  Diagnosis of solid tumor, Hodgkin's lymphoma, or B-cell non-Hodgkin's lymphoma

 -  Eligible for autologous stem cell transplantation

 -  No pleural effusion, pericardial effusion, or ascites

 -  No T-cell lymphoma

 PATIENT CHARACTERISTICS:

 Age:

 -  Under 57

 Performance status:

 -  Karnofsky 80-100%

 Life expectancy:

 -  Not specified

 Hematopoietic:

 -  Not specified

 Hepatic:

 -  Bilirubin no greater than 1.5 mg/dL (unless due to Gilbert's disease)

 -  SGOT or SGPT no greater than 2 times upper limit of normal

 -  Hepatitis B and C negative

 Renal:

 -  Creatinine no greater than 2.0 mg/dL OR

 -  Creatinine clearance at least 60 mL/min

 Cardiovascular:

 -  LVEF at least 50%

 -  No congestive heart disease

 -  No history of myocardial infarction within the past year

 -  No coronary artery disease

 -  No history of arrhythmia

 Pulmonary:

 -  Diffusion capacity (corrected) at least 60%

 -  FEV_1 at least 65% of predicted

 Other:

 -  HIV negative

 -  No history of seizures

 -  No mental disorders requiring medication (e.g., haloperidol)

 -  No active connective tissue disease

 -  No other malignancy within the past 5 years except basal cell or squamous cell skin
 cancer or any carcinoma in situ

 -  No allergy to gentamicin

 -  No hypersensitivity to E. coli-derived preparations

 -  No history of severe allergy to sargramostim (GM-CSF) or filgrastim (G-CSF)

 -  No systemic infection

 -  Not pregnant

 PRIOR CONCURRENT THERAPY:

 Biologic therapy:

 -  See Disease Characteristics

 Chemotherapy:

 -  Not specified

 Endocrine therapy:

 -  No concurrent corticosteroid therapy

 Radiotherapy:

 -  Not specified

 Surgery:

 -  Not specified

 Other:

 -  No contrast dye for 3 weeks after completion of interleukin-2 therapy