Inclusion Criteria:
- Diagnosis B-cell NHL: Burkitt lymphoma, Diffuse Large B Cell Lymphoma, Follicular Lymphoma, Mantle Cell Lymphoma, Marginal Zone Lymphoma, Transformed Follicular Lymphoma, Richter syndrome, and CD20+ Hodgkin Lymphoma.
- Disease Status Primary Induction Failure, 1st, 2nd or 3rd relapse/progression having attained a CR, PR, or stable disease post reinduction therapy.
- Performance Level Patients must have a performance status ≥ 50%. Use Karnofsky for patients > 16 years of age and Lansky for patients less than or equal to 16 years of age. See Appendix I for performance score.
- Life Expectancy Patients must have a life expectancy of > 6 weeks.
- Prior Therapy Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study.
1. Myelosuppressive chemotherapy: Must not have received within 2 weeks of entry onto this study (4 weeks if prior nitrosourea).
2. Biologic (anti-neoplastic agent): At least 7 days since the completion of therapy with a biologic agent.
- Organ Function Requirements
Adequate Renal Function Defined As:
- Creatinine clearance or radioisotope GFR > 60 mL/min/1.73 m2 or
- A serum creatinine based on age/gender as follows:
Age Maximum Serum Creatinine (mg/dL) Male Female
- 12 to < 13 years 1.2 1.2 13 to < 16 years 1.5 1.4
- 16 years 1.7 1.4
- Adequate Liver Function Defined As:
- Total bilirubin less than or equal to 1.5 x upper limit of normal (ULN) for age, and
- SGOT (AST) or SGPT (ALT) < 3 x upper limit of normal (ULN) for age for presumed hepatic leukemia or lymphoma.
- Adequate Cardiac Function Defined As:
- Shortening fraction of > 27% by echocardiogram, or
- Ejection fraction of > 50% by radionuclide angiogram.
- Adequate Pulmonary Function Defined As:
• Normal respiratory rate for age and a pulse oximetry > 94% on room air unless due to underlying malignancy.
- Peripheral Blood Stem Cell Collection
• Patients have a target of 5.0 x 106 CD34 (minimum of 2.5 x 106 CD34) PBSC collected and cryopreserved prior to start of myeloablative conditioning
- All patients and/or their parents or legal guardians must sign a written informed consent.
Exclusion Criteria:
- Patient may not have had a prior stem cell transplant
- Patients must not have active CNS lymphoma
- Other concurrent investigational agents for treatment of B-cell lymphoma
- Pregnancy and/or active Breast Feeding
- Sexually active patients of reproductive potential are not eligible unless they have agreed to use an effective contraceptive method for the duration of their study participation.
- Patient must not have an uncontrolled infection.
- Patient must not have ≥ Grade 3 neuropathy.