Holmium Ho 166 DOTMP Followed by Peripheral Stem Cell Transplantation in Treating Patients With Metastatic Ewing's Sarcoma or Rhabdomyosarcoma That Has Spread to the Bone

OBJECTIVES:

• Determine the dosimetry of holmium Ho 166 DOTMP in patients with metastatic Ewing's sarcoma family of tumors or rhabdomyosarcoma with bone metastases.
• Provide treatment with holmium Ho 166 DOTMP for these patients.
• Determine the toxicity and pharmacokinetics of this drug in these patients.
• Determine the change in tumor cell content in peripheral blood and bone marrow after treatment with this drug in these patients.

OUTLINE: Patients receive a trace dose of holmium Ho 166 DOTMP IV over 10 minutes on day -7 and an assigned dose over 10 minutes on day 0. Autologous peripheral blood stem cells are infused on days 7-10.

Patients are followed at least weekly for 4 weeks and then monthly for 1 year or until disease progression.

PROJECTED ACCRUAL: A total of 4 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

• Histologically confirmed Ewing's sarcoma family of tumors or rhabdomyosarcoma with bone metastases

• Refractory to conventional therapy OR
• Responsive to conventional therapy with osseous metastases at diagnosis that are extensive enough to preclude concurrent radiotherapy to all sites
• Soft tissue, pulmonary, and/or bone marrow metastases in addition to cortical bone allowed

• Extraosseous sites of disease allowed if amenable to surgical resection or external beam radiotherapy
• No patients under 10 years old with embryonal rhabdomyosarcoma
• Adequate peripheral blood stem cells stored

• At least 2,500,000 CD34+ cells/kg
• No impending bone fracture or spinal cord compression

PATIENT CHARACTERISTICS:

Age:

• 12 and over

Performance status:

• 0-2

Life expectancy:

• At least 2 months

Hematopoietic:

• Absolute neutrophil count at least 1,000/mm^3
• Platelet count at least 75,000/mm^3 (transfusion independent)
• Hemoglobin at least 10.0 g/dL (RBC transfusion allowed)

Hepatic:

• Bilirubin no greater than 1.5 times normal
• SGOT no greater than 2.5 times normal

Renal:

• Radioisotope glomerular filtration rate, iothalamate clearance, or creatinine clearance at least 60 mL/min

Other:

• No uncontrolled infection
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Recovered from prior immunotherapy
• At least 3 months since prior bone marrow or peripheral blood stem cell transplantation (6 months for total body irradiation conditioning) and recovered
• At least 1 week since prior cytokines
• No immunomodulators during and for at least 4 weeks after study
• No concurrent cytokines

Chemotherapy:

• At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas) and recovered
• No more than 3 prior systemic chemotherapy regimens
• No systemic chemotherapy during and for at least 4 weeks after study

Endocrine therapy:

• Not specified

Radiotherapy:

• See Disease Characteristics
• See Biologic therapy
• Recovered from prior radiotherapy
• No prior maximum tolerable radiotherapy (greater than 30 Gy) to the spinal cord
• No prior therapeutic doses of bone-seeking radiopharmaceutical (e.g., samarium Sa 153 lexidronam pentasodium EDTMP)
• No radiotherapy during and for at least 4 weeks after study

• Local radiotherapy to any tumor site allowed provided at least 1 evaluable lesion is untreated

Surgery:

• See Disease Characteristics
• No surgical resection of all bone metastases evaluable by PET during and for 1 month after study

Other:

• At least 4 weeks since prior bisphosphonates