Combination Chemotherapy, Peripheral Stem Cell Transplantation, and Biological Therapy in Treating Patients With 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