Combination Chemotherapy Followed by Peripheral Stem Cell Transplantation in Treating Children With Relapsed Acute Lymphocytic Leukemia

DISEASE CHARACTERISTICS:

• Diagnosis of acute lymphoblastic leukemia

  • Pathologic evidence of relapse in marrow, CNS, or testes
  • In second or later complete remission

• Ineligible for allogeneic transplantation:

  • No suitable allogeneic donor (sibling or family donor or unrelated donor with no more than 1 HLA-A or -B antigen mismatch and HLA-DR identical) OR
  • Ineligible for preparative regimen including total-body irradiation

• Peripheral blood stem cell collection feasible:

  • Patient size generally at least 8 kg
  • Able to place central venous catheter
  • Patient cooperative

PATIENT CHARACTERISTICS:

Age:

• 1 to 19

Performance status:

• Not moribund

Life expectancy:

• No severe limits from disease other than leukemia

Hepatic:

• Bilirubin no greater than 3 times normal for age
• AST and/or GGT no greater than 3 times normal for age
• No evidence of hepatic synthetic dysfunction

Renal:

• GFR at least 50% of normal based on Glofil study or 12-hour creatinine clearance

Cardiovascular:

• Cardiac contractility normal on echocardiogram

Pulmonary:

• FVC and FEV_1 with or without DLCO at least 50% predicted

Other:

• No significant active infection
• HIV negative

PRIOR CONCURRENT THERAPY:

Biologic therapy

• See Disease Characteristics

Chemotherapy

• See Disease Characteristics

Endocrine therapy

• Not specified

Radiotherapy

• See Disease Characteristics

Surgery

• Not specified