Cyclophosphamide, Fludarabine, and Total-Body Irradiation Followed By Cellular Adoptive Immunotherapy, Autologous Stem Cell Transplantation, and Interleukin-2 in Treating Patients With Metastatic Melanoma

DISEASE CHARACTERISTICS:

• Diagnosis of metastatic melanoma
• Measurable disease
• Resected or stable brain metastases are allowed

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• Eastern Cooperative Oncology Group (ECOG) 0-1

Life expectancy

• At least 3 months

Hematopoietic

• See Immunologic
• Absolute neutrophil count > 1,000/mm^3 (without support of filgrastim [G-CSF])
• Platelet count > 100,000/mm^3
• Hemoglobin ≥ 8 g/dL (transfusion allowed)
• No coagulation disorders

Hepatic

• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 3 times upper limit of normal
• Bilirubin ≤ 2 mg/dL (< 3 mg/dL in patients with Gilbert's syndrome)
• No hepatitis B or C

Renal

• Creatinine ≤ 1.6 mg/dL

Cardiovascular

• Left ventricular ejection fraction (LVEF) ≥ 45% by cardiac stress test*
• No active major cardiovascular illness as evidenced by stress thallium or other comparable test
• No myocardial infarction
• No cardiac arrhythmias NOTE: *For patients ≥ 50 years of age receiving high-dose interleukin-2 (IL-2) OR patients with a history of electrocardiogram (EKG) abnormalities, symptoms of cardiac ischemia, or arrhythmias

Pulmonary

• Forced expiratory volume 1 (FEV_1) ≥ 60% of predicted by pulmonary function test in patients with prolonged history of cigarette smoking or symptoms of respiratory dysfunction*
• No active major respiratory illness
• No obstructive or restrictive pulmonary disease NOTE: *For patients receiving high-dose IL-2 only

Immunologic

• No active major immunologic illness
• No active systemic infections

• No primary or secondary immunodeficiency

  • Fully recovered immune competence after prior chemotherapy or radiotherapy as evidenced by both of the following:

    • Absolute neutrophil count > 1,000/mm^3
    • No opportunistic infections
• Human Immunodeficiency virus (HIV) negative
• Epstein-Barr virus positive

Other

• Not pregnant or nursing
• Fertile patients must use effective contraception during and for 4 months after study treatment

PRIOR CONCURRENT THERAPY:

Biologic therapy

• See Disease Characteristics

Chemotherapy

• At least 6 weeks since prior nitrosourea therapy
• No prior cyclophosphamide and fludarabine as part of a preparative regimen on National Cancer Institute (NCI) Surgery Branch adoptive cell therapy studies unless sufficient numbers of CD34+ stem cells (more than 2 x10^6/kg patient weight) have been obtained prior to the administration of chemotherapy

Endocrine therapy

• No concurrent systemic steroid therapy

Radiotherapy

• Not specified

Surgery

• See Disease Characteristics
• Prior minor surgery within the past 3 weeks allowed if recovered

Other

• Recovered from all prior therapy
• At least 30 days since prior systemic therapy
• No other concurrent experimental agents