RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
so they stop growing or die. Combining chemotherapy with peripheral stem cell
transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill
more cancer cells.
PURPOSE: Phase II trial to study the effectiveness of high-dose radiation therapy and
etoposide followed by peripheral stem cell transplantation in treating patients with acute
OBJECTIVES: I. Evaluate the efficacy of myeloablative total-body irradiation and etoposide
followed by autologous peripheral blood stem cell (PBSC) transplantation in prolonging the
disease-free survival of patients with acute leukemia. II. Investigate the ability of growth
factor-primed PBSC to provide hematopoietic reconstitution following myeloablative therapy.
OUTLINE: Patients are treated on Regimen A, then Regimen B. Regimen A: Stem Cell
Mobilization. Granulocyte Colony Stimulating Factor (Amgen), G-CSF, NSC-614629. Regimen B:
Radiotherapy and Myeloablative Chemotherapy with Hematopoietic Rescue. Total-Body
Irradiation, TBI (high-energy electrons used for lung boost); and Etoposide, VP-16,
NSC-141540; with Peripheral Blood Stem Cells, PBSC; G-CSF.
PROJECTED ACCRUAL: Up to 45 patients will be studied over approximately 3 years.
DISEASE CHARACTERISTICS: Previously diagnosed acute leukemia in one of the following
categories: Acute myelogenous leukemia (any subtype) in first or subsequent remission Ph+
acute lymphoblastic leukemia (ALL) in first or greater remission Ph- ALL in second or
subsequent remission Cellular marrow with no morphologic evidence of residual leukemia
within approximately 2 weeks of cryopreservation Negative CSF cytology required of ALL
patients Allogeneic marrow transplant considered for patients under age 55 with a healthy
HLA-identical family member available
PATIENT CHARACTERISTICS: Age: Over 16 to 65 Performance status: Not specified
Hematopoietic: WBC greater than 3,500/mm3 Platelet count greater than 100,000/mm3 Hepatic:
Bilirubin less than 2.0 mg/dl Renal: Creatinine no greater than 1.5 mg/dl OR Creatinine
clearance at least 60 ml/min Cardiovascular: LVEF at least 50% by MUGA or normal on
echocardiogram Pulmonary: DLCO at least 50% of predicted Other: HIV seronegative No
uncontrolled infection Negative pregnancy test required of fertile women
PRIOR CONCURRENT THERAPY: See Disease Characteristics