Radiolabeled Monoclonal Antibody With or Without Peripheral Stem Cell Transplantation in Treating Children With Recurrent or Refractory Lymphoma

Inclusion Criteria:

• Histologically confirmed and immunophenotypically (CD20)-positive lymphoma at original diagnosis, progression, or relapse

• Refractory to conventional therapy

  • First recurrent/refractory CD20-positive non-Hodgkin's lymphoma (NHL) allowed if ineligible for or refused regimens with known curative potential (high-dose chemotherapy plus bone marrow transplantation) (if available)
  • Second or third progression and/or recurrence of NHL
  • Second or third relapse/refractory CD20-positive Hodgkin's lymphoma
  • CD20-positive, post-transplantation lymphoproliferative lymphoma that is medically refractory (decreased immunosuppression) to rituximab and/or chemotherapy
  • Medically refractory, HIV-associated, CD20-positive NHL
  • Recurrent/refractory CD20-positive lymphoblastic lymphoma
• Autologous peripheral blood stem cells (PBSC) collected, selected for a minimum of 2 x 10^6 CD34-positive cells per kg, and cryopreserved before study entry

• Meets one of the following criteria for bone marrow reserve:

  • Good marrow reserve, defined by both of the following:

    • No prior myeloablative stem cell transplantation (SCT)

    • No prior extensive radiotherapy, defined by any of the following:

      • Prior total body irradiation
      • Prior radiotherapy dose of 3,600 cGy or more to cranio-spinal axis
      • Prior radiotherapy to 50% or more of bone marrow

  • Poor marrow reserve, defined by either or both of the following:

    • Prior myeloablative SCT
    • Prior extensive radiotherapy
• Performance status - Lansky 50-100% (age 10 and under)
• Performance status - Karnofsky 50-100% (age 11 to 21)
• At least 2 months
• Absolute neutrophil count ≥ 1,000/mm^3
• Platelet count ≥ 100,000/mm^3 for patients with poor marrow reserve (transfusion independent)
• Platelet count ≥ 150,000 for patients with good marrow reserve (transfusion independent)
• Hemoglobin ≥ 8.0 g/dL (transfusion allowed)
• Bilirubin ≤ 1.5 times upper limit of normal (ULN)
• ALT ≤ 5 times ULN
• Albumin ≥ 2 g/dL
• Creatinine normal
• Creatinine clearance or glomerular filtration rate ≥ 70 mL/min
• Shortening fraction ≥ 27% by echocardiogram
• Ejection fraction ≥ 50% by MUGA
• No dyspnea at rest
• No exercise intolerance
• Oxygen saturation (SpO_2) > 94% by pulse oximetry (if there is a clinical indication for SpO_2 assessment)
• Not pregnant or nursing
• Negative pregnancy test
• No documented infection that is unresponsive to appropriate antibiotic, antiviral, or antifungal therapy
• No grade 2 or greater CNS toxicity
• Seizure disorder allowed if well controlled and on anticonvulsants
• See Disease Characteristics
• Recovered from prior immunotherapy
• At least 1 week since prior antineoplastic biologic agents

• Prior SCT allowed if the following criteria are met:

  • At least 60 days since prior SCT
  • Full hematopoietic reconstitution post-SCT
• No evidence of active acute or chronic graft-versus-host disease if post- allogeneic SCT
• No concurrent sargramostim (GM-CSF)
• See Disease Characteristics
• At least 3 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosourea) and recovered
• See Disease Characteristics
• Recovered from prior radiotherapy
• No concurrent medications that would interact with the study drug