Tandem Peripheral Blood Stem Cell (PBSC) Rescue for High Risk Solid Tumors

Inclusion Criteria:

• Malignant Diseases:

  • Ewing's sarcoma/PNET:

    • CR1 - Metastatic disease at diagnosis, tumor volume > 100 ml, pelvic bone primary
    • CR2 - Locally recurrent disease

  • Soft tissue sarcoma

    • CR1 - Metastatic disease at diagnosis or locally advanced disease where local control is suboptimal (i.e., inability to provide radiation therapy due to extent of disease).
    • CR2 - Locally recurrent disease (VGPR2 acceptable)

  • Hepatoblastoma:

    • VGPR1 - Patients with metastatic disease at diagnosis who have a persistently elevated alpha FP, or unresectable primary as a way of converting to resectable.
    • CR2/VGPR2

  • Hodgkin's Disease:

    • VGPR1 - Progression on primary therapy/Refractory disease
    • CR2/VGPR2

  • Germ Cell Tumor:

    • CR2/VGPR2 - recurrent disease

  • Wilms Tumor:

    • CR2/VGPR2 - recurrent disease
• IRB approved signed written informed consent by patient and/or their legally authorized guardian.
• Patients 21 years of age or younger at initial diagnosis, with older patients considered individually for primary pediatric disease diagnosis.
• Adequate central venous access (double lumen CVL or 2 single lumen PCVC).
• Adequate PBSC harvests with a minimum of 2.0 x 108 MNC/kg available for each PBSC rescue.

• Organ Function:

  • Platelets > 50,000/ml
  • SGOT < 10 x upper limits of normal
  • Creatinine < 1.5 x normal baseline
  • Normal cardiac function in accordance with institutional policies
  • Normal pulmonary function in accordance with institutional policies.

• Physiologic status:

  • No active infections
  • Adequate performance status as measured by Karnofsky (> 70%) or Lansky scale (> 60%) as appropriate for age.

• Bone Marrow Status

  • No evidence of morphologic involvement with tumor at the time of transplant

Off Study Criteria:

• Severe toxicity. Contact the Study Coordinator immediately and complete Adverse Reaction Form.
• Disease progression or relapse prior to PBSC #1 or between PBSC rescue # 1 and #2.
• Inability to collect adequate numbers of PBSC for successful transplantation.
• Patient or parent/guardian refusal to remain on study.