Topotecan, High-Dose Cyclophosphamide, Carboplatin, and an Autologous Peripheral Blood Cell Transplant in Treating Patients With Recurrent Ovarian Cancer or Primary Peritoneal Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed ovarian epithelial or primary peritoneal cavity cancer

  • Recurrent, relapsed, or persistent disease meeting 1 or more of the following criteria:

    • Patients with a positive second-look laparotomy who are not candidates for higher priority GOG protocols
    • Largest mass of recurrent disease ≤ 0.2 cm achieved by surgery or chemotherapy
    • Achievement of complete response to 1 prior regimen of platinum-based chemotherapy with relapse > 6 months from last chemotherapy
    • Achievement of partial response to 1 platinum-based chemotherapy regimen prior to study
  • Histological proof of disease recurrence with or without a rising serum CA-125 level (relapsed or recurrent disease)

• The following histological cell types are allowed:

  • Clear-cell adenocarcinoma
  • Endometrioid adenocarcinoma
  • Mixed epithelial carcinoma
  • Mucinous adenocarcinoma
  • Serous adenocarcinoma
  • Undifferentiated carcinoma
• Must have unilateral bone marrow aspirate and biopsy with cytogenetics without evidence of metastatic ovarian carcinoma by conventional morphology within 1 month of registration
• Not eligible for GOG-164

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Creatinine ≤ 1.5 mg/dL
• Total bilirubin ≤ 2.0 mg/dL (≤ 5.0 mg/dL with metastatic disease)
• AST ≤ 2 times upper limit of normal (ULN) (≤ 600 units/mL with metastatic disease)
• Alkaline phosphatase ≤ 2 times ULN (unless related to metastatic disease)
• ANC ≥ 1,000/mm^3
• Platelets ≥ 100,000/mm^3
• Cardiac ejection fraction ≥ 45% by rest ECHO or MUGA
• FEV_1 ≥ 50% of predicted
• HIV negative
• No uncontrolled infection

• No severe medical or psychiatric illness, including any of the following:

  • Renal failure
  • Brittle insulin dependent diabetes mellitus
  • Congestive heart failure
  • History of myocardial infarction within the past 3 months
  • Significant arrhythmia requiring medication
  • Poorly controlled hypertension (diastolic blood pressure >100 mm Hg)
  • History of hospitalization for severe depression or psychosis
  • Significant non-neoplastic pulmonary disease
  • Current alcohol or drug abuse.
  • Active infection
  • Active peptic ulcer disease
• No prior malignancy within the past 5 years except adequately treated basal cell or squamous cell carcinoma of the skin or in situ cervical carcinoma

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No more than 1 prior treatment regimen for this cancer
• More than 3 weeks since surgery
• No prior topotecan hydrochloride