High-Dose Thiotepa With Autologous Stem Cell Rescue in Patients With Malignancies Refractory to Conventional Chemotherapy

Fecha de inicio: 1 de septiembre de 1997

DISEASE CHARACTERISTICS: Malignant solid tumors Must have failed conventional treatment or for whom conventional therapy is not available Measurable disease by MRI or CT scan Intraocular retinoblastomas may be measured by direct visualization Germ cell tumors may be measured by tumor markers No known bone marrow involvement PATIENT CHARACTERISTICS: Age: Any age Performance status: Lansky 60-100% for patients 16 and under Karnofsky 60-100% for patients over 16 Life expectancy: At least 8 weeks Hematopoietic: Absolute neutrophil count at least 1,000/mm^3 Platelet count at least 75,000/mm^3 If parameters not met, must have adequate stem cell yield Hepatic: Bilirubin no greater than 1.5 times the upper limit of normal (ULN) SGOT and SGPT no greater than 2.5 times the ULN (unless liver involvement by tumor) Renal: Creatinine within normal limits OR Creatinine clearance at least 70 mL/min Cardiovascular: Fractional shortening greater than 28% on echocardiogram OR Ejection fraction at least 55% on RNCA prior to first cycle of thiotepa Pulmonary: DLCO greater than 55% of predicted (only required if there is clinical evidence of pulmonary dysfunction) Other: Not pregnant or nursing Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: Prior bone marrow or peripheral blood stem cell rescue allowed Chemotherapy: At least 4 weeks since prior chemotherapy if absolute neutrophil count is less than 1,000/mm^3 or platelet count is less than 75,000/mm^3, and recovered (i.e. adequate stem cells collected to predict hematopoietic recovery) No concurrent chemotherapy except for dexamethasone for antiedema effects Endocrine therapy: No concurrent use of corticosteroids used solely as antiemetics Radiotherapy: At least 4 weeks since radiotherapy if absolute neutrophil count is less than 1,000/mm^3 or platelet count is less than 75,000/mm^3, and recovered (i.e. adequate stem cells collected to predict hematopoietic recovery) No concurrent radiotherapy Surgery: Not specified