Chemotherapy, Radiation Therapy, and Umbilical Cord Blood Transplantation in Treating Patients With Hematologic Cancer
Condition: Graft Versus Host Disease; Leukemia; Lymphoma; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes
MeSH terms: Lymphoma; Leukemia; Multiple Myeloma; Neoplasms, Plasma Cell; Preleukemia; Plasmacytoma; Myelodysplastic Syndromes; Graft vs Host Disease; Syndrome
Intervention: anti-thymocyte globulin; filgrastim; busulfan; cyclophosphamide; cyclosporine; methylprednisolone; bone marrow ablation with stem cell support; umbilical cord blood transplantation; radiation therapy
Intervention description: IV; IV; IV; IV; IV; IV; IV; IV; High energy X-rays
Intervention MeSH terms: Cyclosporine; Methylprednisolone; Cyclophosphamide; Busulfan; Cyclosporins; Antilymphocyte Serum
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 20.0
Sex: All
Minimum age: 5 Years
Maximum age: 50 Years
Healthy volunteers: No
Keywords: recurrent childhood acute lymphoblastic leukemia; recurrent adult Hodgkin lymphoma; Burkitt lymphoma; refractory multiple myeloma; stage I multiple myeloma; stage II multiple myeloma; stage III multiple myeloma; recurrent childhood lymphoblastic lymphoma; recurrent childhood acute myeloid leukemia; recurrent adult acute myeloid leukemia; recurrent adult acute lymphoblastic leukemia; relapsing chronic myelogenous leukemia; childhood diffuse large cell lymphoma; childhood immunoblastic large cell lymphoma; chronic phase chronic myelogenous leukemia; accelerated phase chronic myelogenous leukemia; blastic phase chronic myelogenous leukemia; meningeal chronic myelogenous leukemia; adult acute myeloid leukemia in remission; adult acute lymphoblastic leukemia in remission; childhood acute myeloid leukemia in remission; childhood acute lymphoblastic leukemia in remission; recurrent/refractory childhood Hodgkin lymphoma; recurrent grade 1 follicular lymphoma; recurrent grade 2 follicular lymphoma; recurrent grade 3 follicular lymphoma; recurrent adult diffuse small cleaved cell lymphoma; recurrent adult diffuse mixed cell lymphoma; recurrent adult diffuse large cell lymphoma; recurrent adult immunoblastic large cell lymphoma; recurrent adult lymphoblastic lymphoma; recurrent adult Burkitt lymphoma; secondary acute myeloid leukemia; de novo myelodysplastic syndromes; previously treated myelodysplastic syndromes; secondary myelodysplastic syndromes; graft versus host disease; recurrent childhood small noncleaved cell lymphoma; recurrent childhood large cell lymphoma; recurrent mantle cell lymphoma; recurrent marginal zone lymphoma; recurrent small lymphocytic lymphoma; extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue; nodal marginal zone B-cell lymphoma; splenic marginal zone lymphoma; childhood myelodysplastic syndromes

Summary:

      RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
      so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer
      cells. Umbilical cord blood transplantation may allow doctors to give higher doses of
      chemotherapy or radiation therapy and kill more cancer cells.

      PURPOSE: Phase II trial to study the effectiveness of chemotherapy, radiation therapy, and
      umbilical cord blood transplantation in treating patients with hematologic cancer.
    

Eligibility criteria:

        DISEASE CHARACTERISTICS: Histologically proven hematologic malignancy Acute lymphocytic
        leukemia (ALL): In second or later remission In first remission with poor prognostic
        features (Philadelphia chromosome positive) Acute myeloid leukemia (AML): In second or
        later remission In first remission with poor prognostic features, e.g., Arising from
        myelodysplastic syndrome Cytogenetics with -5, -7, +8, 11q23 abnormalities Complex
        cytogenetics AML or ALL refractory to induction or in relapse Myelodysplastic syndrome
        Chronic myelogenous leukemia Severe aplastic anemia or Fanconi's anemia Relapsed Hodgkin's
        disease Relapsed non-Hodgkin's lymphoma Multiple myeloma No suitable family donor matched
        for 5 or 6 HLA antigens (A, B, DR) No suitable unrelated donor matched for 6 HLA antigens
        Cord blood donor available matched for 4-6 out of 6 HLA antigens

        PATIENT CHARACTERISTICS: Age: 5 to 50 Performance status: Karnofsky 70-100% Life
        expectancy: Not specified Hematopoietic: Not specified Hepatic: Bilirubin less than 3 times
        normal Alkaline phosphatase less than 3 times normal SGOT less than 3 times normal Renal:
        Creatinine less than 2 times normal OR Creatinine clearance greater than 60 mL/min
        Cardiovascular: MUGA with ejection fraction at least 50% Pulmonary: DLCO and spirometry at
        least 60% OR Exercise VO2 max/kg at least 15 mL/min/kg Other: HIV antibody negative
        Hepatitis B surface antigen negative No active bacterial, viral, or fungal infection

        PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: Not specified
        Endocrine therapy: Not specified Radiotherapy: Prior radiotherapy allowed If following
        limits have not been exceeded, patient may receive total body irradiation: No prior
        radiation to one entire kidney Whole liver received no greater than 1000 cGy No prior whole
        abdomen radiotherapy Small bowel received no greater than 3000 cGy Heart received no
        greater than 1800 cGy No prior whole lung radiotherapy CNS received less than 30 cGy (whole
        brain or any portion of the spine) Surgery: Not specified