RATIONALE: Giving high-dose chemotherapy drugs, such as carmustine, etoposide, and cyclophosphamide, before a peripheral blood stem cell transplant stops the growth of cancer cells by stopping them from dividing or killing them. After treatment, stem cells that were collected from the patient's blood are returned to the patient to replace the blood-forming cells that were destroyed by the chemotherapy. PURPOSE: This clinical trial is studying the side effects of giving high-dose carmustine, etoposide, and cyclophosphamide together with a stem cell transplant and to see how well it works in treating patients with HIV-associated lymphoma.
OBJECTIVES: Primary * To evaluate the feasibility and toxicity of high-dose chemotherapy comprising carmustine, etoposide, and cyclophosphamide followed by autologous stem cell infusion in patients with HIV-associated lymphoma receiving combination anti-HIV therapy and to determine the efficiency of stem cell collection from these patients. * To estimate the disease-free and overall survival of patients treated with this regimen. * To evaluate HIV viral load, CD+4/CD+8 counts, and immune recovery after high-dose anti- lymphoma chemotherapy. * To determine the pharmacokinetics of high-dose etoposide in patients receiving highly active anti-retroviral therapy (HAART). OUTLINE: Patients undergo leukapheresis to obtain peripheral blood stem cells (PBSCs) for transplantation. At least 5 days later, patients with an adequate number of collected cells proceed to high-dose chemotherapy. * High-dose chemotherapy: Patients receive carmustine IV over 4 hours on days -7 to -5, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. * Autologous PBSC transplantation: Patients receive PBSC infusion on day 0. Patients undergo blood sample collection periodically for pharmacokinetic studies of etoposide. After completion of study treatment, patients are followed at approximately 30 days and 100 days, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
25
150 mg/m2 day -7, -6,and -5 prior to stem cell reinfusion
100 mg/kg on day -2 prior to stem cell reinfusion
60 mg/kg on day -4 prior to stem cell reinfusion
Prior to start of etoposide infusion, 2 hours after start of infusion, just prior to the end of infusion, then at 0.5, 1, 2, 4, 24 and 48 hours after the end of infusion
Reinfusion of autologous stem cells
Reinfusion of autologous stem cells
City of Hope Medical Center
Duarte, California, United States
Number of days to engraftment as defined by the standard operating procedures of the department of biostatistics at the City of Hope
Time frame: Day 100 post stem cell reinfusion
Feasibility and treatment-associated toxicity of this regimen
Time frame: 1 year post stem cell reinfusion
Ability to mobilize adequate numbers of peripheral blood stem cells (2.5 x 10e6 CD34+cells)
Time frame: At the completion of stem cell collection
Disease-free and overall survival
Time frame: 2 years post stem cell reinfusion
HIV viral load, CD4+/CD8+ counts, and immune recovery
Time frame: 2 years post stem cell reinfusion
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