Gemcitabine and Hodgkin's Disease Chemotherapy Followed by Peripheral Blood Stem Cell Rescue for Hodgkin's Disease

This is a phase 2 study of gemcitabine + high-dose chemotherapy followed by peripheral blood stem cell (PBSC) rescue for Hodgkin's Disease

To assess the non-hematologic toxicity and determine the phase 2 dose of gemcitabine in combination with vinorelbine followed by carmustine, etoposide and cyclophosphamide and autologous hematopoietic stem cell transplantation \[aka peripheral blood stem cell (PBSC)\].

Eligibility Criteria:
Inclusion Criteria:

* Histologically-proven recurrent or refractory Hodgkin's Disease (Hodgkin's lymphoma) on the basis of excisional biopsy whenever possible.
* Age \< 70 years
* Eastern Cooperative Oncology Group (ECOG) performance status 0 to 3.
* Phase 1 study component only: 1 or more of the following adverse risk factors

  * Stage IV extranodal disease at relapse "B" symptoms
  * Failure to achieve minimal disease with most recent chemotherapy (single lymph nodes \< 2 cm or \>75% reduction in a bulky tumor mass and bone marrow involvement \< 10%)
  * Progression during induction or salvage therapy
* Phase 2 study component only: No risk factor criteria
* Computerized tomography (CT) scan of the chest, abdomen and pelvis, with assessment of response to last chemotherapy, within 4 weeks of registration. Gallium scan or positron emission tomography (PET) scan confirmation of disease within 4 weeks of registration is highly recommended
* Bone marrow biopsy and cytogenetic analysis within 8 weeks of registration
* Women of child-bearing potential and sexually active males expected to use an accepted and effective method of birth control
* Pretreatment serum bilirubin \< 2 x the institutional upper limit of normal (ULN) (within 28 days prior to registration)
* Serum creatinine \< 2 x the institutional ULN (within 28 days prior to registration)
* Measured or estimated creatinine clearance \> 60 cc/min by the following formula (within 28 days prior to registration):

  * Estimated Creatinine Clearance = (140 age) x WT(kg) x 0.85 (if female) x creatinine (mg/dL)
* Electrocardiogram (ECG) demonstrating no significant abnormalities suggestive of active cardiac disease (within 42 days prior to registration)
* Patients over age 50, who have received chest irradiation or a total of 300 mg/m2 of doxorubicin or with any history of cardiac disease must have a radionuclide ejection fraction (within 42 days prior to registration). If the ejection fraction is 40 to 50%, the patient will have a cardiology consult
* Corrected diffusion capacity \> 55%
* Written informed consent in accordance with institutional and federal guidelines

Exclusion Criteria:

* Positive HIV antibody test (must be conducted within 42 days of registration)
* No chemotherapy other than corticosteroids should be administered within 2 weeks of the initiation of protocol therapy
* Pregnant
* Breast-feeding
* Requiring therapy for:

  * Coronary artery disease
  * Cardiomyopathy
  * Dysrhythmia, or
  * Congestive heart failure
* Over age 50 and has received chest irradiation or a total of 300 mg/m\^2 of doxorubicin
* History of cardiac disease and the ejection fraction is \< 40% (radionuclide ejection fraction must be within 42 days of registration)
* Known allergy to etoposide
* History of Grade 3 hemorrhagic cystitis with cyclophosphamide
* History of grade 2 or greater sensory or motor peripheral neuropathy due to prior vinca alkaloid use
* No prior malignancy (EXCEPTION: adequately treated basal cell or squamous cell skin cancer; in situ cervical cancer; or other cancer for which the patients has been disease-free for 5 years). Patients with a prior diagnosis of non-Hodgkin's lymphoma are not eligible.