Tanespimycin in Treating Young Patients With Recurrent or Refractory Leukemia or Solid Tumors

Inclusion Criteria:

• Histologically confirmed diagnosis of 1 of the following malignancies:

  • Leukemia

    • Lymphoid, myeloid, or mixed lineage

    • Relapsed (in second or greater relapse) or refractory disease, confirmed by 1 of the following:

      • Bone marrow relapse, defined as either M3 bone marrow (> 25% blasts in the bone marrow aspirate) OR M2 bone marrow (5-25% blasts in the bone marrow aspirate) at any time after complete remission is attained
      • CNS relapse, defined as at least 5 WBC/mL by cytospin of any cerebrospinal fluid (CSF) specimen OR less than 5 WBC/mL by cytospin of 2 consecutive CSF specimens obtained >= 4 weeks apart and having definitive confirmation that blasts are derived from the original leukemic clone by molecular cytogenetics, multiparameter flow cytometry, or immunostaining of >= 2 antigens
    • Patients with underlying chronic myeloid leukemia must have > 25% blasts in the bone marrow aspirate
    • Patients with M3 bone marrow AND extramedullary sites of disease, other than leptomeningeal disease, are eligible

  • Solid tumor

    • One of the following tumor types:

      • Neuroblastoma
      • Ewing's sarcoma
      • Osteosarcoma
      • Desmoplastic small round cell tumor
      • Rhabdomyosarcoma
    • Progressed after prior standard therapy OR no effective standard therapy exists
    • Measurable or nonmeasurable disease
• No known brain metastases

• No active leptomeningeal leukemia, defined by the following criteria:

  • WBC > 5/mm^3 in cerebrospinal fluid (CSF)
  • Unequivocal confirmation of leukemic blasts in CSF by cell morphology
• No symptomatic CNS disease (e.g., cranial nerve abnormalities) without cytologic abnormality in CSF
• Performance status - Karnofsky 70-100% (for patients > 10 years of age)
• Performance status - Lansky 70-100% (for patients =< 10 years of age)
• More than 8 weeks
• Absolute neutrophil count >= 750/mm^3
• Platelet count >= 75,000/mm^3 (transfusion independent)
• Hemoglobin >= 8.5 g/dL (transfusion allowed)
• Bilirubin < 1.5 mg/dL
• ALT and AST =< 2.5 times upper limit of normal (ULN)
• INR =< 1.5 times ULN
• Albumin > 2.0 g/dL
• Creatinine =< 1.5 times ULN for age
• Creatinine clearance or radioisotope glomerular filtration rate > 60 mL/min
• Ejection fraction >= 50%
• Shortening fraction >= 28%

• QTc < 450 msec for men (470 msec for women)

  • No congenital long QT syndrome
• LVEF > 40% by MUGA
• No symptomatic congestive heart failure
• No cardiac arrhythmia
• No New York Heart Association class III or IV heart failure
• No myocardial infarction within the past year
• No uncontrolled dysrhythmias
• No poorly controlled angina
• More than 12 months since active ischemic heart disease
• No history of serious ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation >= 3 beats in a row)
• No left bundle branch block
• No other significant cardiac disease
• No pulmonary fibrosis by radiography
• No ongoing or active bacterial or fungal infection
• No other uncontrolled illness
• No psychiatric illness or social situation that would preclude study compliance
• No history of serious allergic reaction attributed to eggs or dimethyl sulfoxide
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Recovered from all immunotherapy
• At least 6 months since prior allogeneic stem cell transplantation
• At least 3 months since prior autologous stem cell transplantation
• At least 2 weeks since prior biologic agents (e.g., monoclonal antibodies)
• At least 1 week since prior filgrastim (G-CSF) or sargramostim (GM-CSF)
• Recovered from all prior chemotherapy
• At least 2 weeks since prior chemotherapy (for patients with leukemia only)
• At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) (for patients with solid tumors)
• No prior oxaliplatin
• No concurrent corticosteroids except for the treatment of adrenal crises in patients with suppressed hypothalamic-pituitary-adrenal axis response OR for treatment of allergic reactions to medications or blood products
• Recovered from all prior radiotherapy
• At least 6 months since prior radiotherapy to >= 50% of the pelvis
• At least 6 months since prior radiotherapy to substantial bone marrow, including total body irradiation
• At least 4 weeks since prior local (small port) radiotherapy
• No prior radiotherapy to the heart
• At least 1 week since prior retinoids
• No concurrent antiretroviral therapy for HIV-positive patients
• No concurrent medication to control arrhythmias
• No concurrent medications that prolong or may prolong QTc interval
• No other concurrent investigational agents
• No other concurrent anticancer therapy