Combination Chemotherapy and Peripheral Stem Cell Transplantation in Treating Patients With Neuroblastoma

DISEASE CHARACTERISTICS:

• Histologically confirmed newly diagnosed neuroblastoma OR ganglioneuroblastoma, and/or evidence of clumps of tumor cells in bone marrow with elevated urinary catecholamine metabolites, meeting 1 of the following criteria:

  • Age greater than 18 months with stage IV disease, regardless of biologic factors

  • Age 12-18 months with stage IV disease meeting one of the following criteria:

    • Any unfavorable biologic feature (e.g., MYCN amplification, unfavorable pathology, and/or DNA index = 1)
    • Any biologic feature that is indeterminate, unsatisfactory, or unknown

• At least 1 year old with the following:

  • Stage IIa/IIb with MYCN amplification (> 10) AND unfavorable pathology
  • Stage III with MYCN amplification (> 10) OR unfavorable pathology

  • Stage I, II, or IVS with disease progression to stage IV without interval chemotherapy

    • No more than 3 weeks since progression
    • Must have been enrolled on protocol CCG-B973, COG-ANBL00B1, or POG-9047

• Less than 1 year old with the following:

  • Stage III, IV, or IVS disease with MYCN amplification (> 10)
• Registration on protocol COG-ANBL00B1 required within 14 days of diagnosis

PATIENT CHARACTERISTICS:

Age:

• See Disease Characteristics
• 30 and under at time of diagnosis

Performance status:

• Not specified

Life expectancy:

• Not specified

Hematopoietic:

• Absolute neutrophil count ≥ 1,000/mm^3
• Platelet count ≥ 100,000/mm^3
• Inadequate hematopoiesis secondary to bone marrow involvement with > 10% tumor infiltration allowed

Hepatic:

• Bilirubin ≤ 1.5 mg/dL
• ALT ≤ 300 units/L

Renal:

• Creatinine ≤ 1.5 mg/dL
• Creatinine clearance or glomerular filtration rate ≥ 60 mL/min

Cardiovascular:

• ECG normal
• Ejection fraction ≥ 55% by echocardiogram or MUGA OR
• Fractional shortening ≥ 28% by echocardiogram

Other:

• Able to tolerate peripheral blood stem cell collection
• HIV negative
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception for at least 1 month prior to, during, and for 1 month after study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• See Disease Characteristics
• No more than 1 prior course of chemotherapy on the Intergroup low/intermediate risk neuroblastoma study (P9641, A3961)

Endocrine therapy:

• Not specified

Radiotherapy:

• Prior localized emergency radiotherapy to sites of life-threatening or function-threatening disease allowed

Surgery:

• Not specified

Other

• No other prior systemic therapy