LMB-2 Immunotoxin in Treating Young Patients With Relapsed or Refractory Leukemia or Lymphoma

DISEASE CHARACTERISTICS:

Histologically confirmed diagnosis of 1 of the following:

Non-Hodgkin's lymphoma, including the following subtypes:

Lymphoblastic lymphoma
Burkitt's lymphoma
Large cell lymphoma
Adult T-cell leukemia/lymphoma
Cutaneous T-cell lymphoma
Peripheral T-cell lymphoma
Hodgkin's disease
Acute myeloid leukemia
Chronic myelogenous leukemia

Acute lymphoblastic leukemia (ALL)

More than 5% blasts in the bone marrow (i.e., M2 marrow classification)

Acute hybrid leukemia, including the following subtypes:

Mixed lineage leukemia
Biphenotypic leukemia
Undifferentiated leukemia

CD25-positive (CD25+) disease, meeting 1 of the following criteria:

More than 15% of malignant cells are CD25+ by immunohistochemistry with anti-CD25 antibody
More than 30% of malignant cells from a site are CD25+ by fluorescence-activated cell sorting analysis
Measurable or evaluable disease
Relapsed or refractory disease after at least 1 standard chemotherapy regimen AND 1 salvage regimen
No available alternative curative therapies
Ineligible for or refused hematopoietic stem cell transplantation OR disease activity that prohibits the required time to identify a suitable stem cell donor

No CNS leukemia or lymphoma, as evidenced by any of the following criteria:

Cerebrospinal fluid (CSF) WBC > 5/µl AND confirmation of CSF blasts
Cranial neuropathies secondary to underlying malignancy

CNS lymphoma detected by radiological imaging

Prior CNS involvement with no current evidence of CNS malignancy allowed
No isolated testicular ALL

PATIENT CHARACTERISTICS:

Age

6 months to 21 years

Performance status

ECOG 0-3 (≥ 12 years of age)
Lansky 40-100% (< 12 years of age)

Life expectancy

Not specified

Hematopoietic

Pancytopenia due to disease allowed

For patients without bone marrow involvement:

Absolute neutrophil count > 1,000/mm^3
Platelet count > 50,000/mm^3 (transfusion independent)

Hepatic

Bilirubin ≤ 2.0 mg/dL
AST and ALT ≤ 5 times upper limit of normal
Hepatitis B surface antigen negative
Hepatitis C antibody negative

Renal

Creatinine clearance ≥ 60 mL/min OR

Creatinine, meeting the following age-related criteria:

≤ 0.8 mg/dL (≤ 5 years of age)
≤ 1.0 mg/dL (6 to 10 years of age)
≤ 1.2 mg/dL (11 to 15 years of age)
≤ 1.5 mg/dL (> 15 years of age)
Calcium 2.0-2.9 mmol/L

Cardiovascular

Ejection fraction ≥ 45% by MUGA OR
Shortening fraction ≥ 28% by echocardiogram

Pulmonary

Oxygen saturation ≥ 90%

Other

Sodium 130-150 mmol/L
Potassium 3.0-5.5 mmol/L
Magnesium 0.5-1.23 mmol/L
HIV negative
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No clinically significant unrelated systemic illness that would preclude study participation
No conditions that would preclude study compliance
No serum that neutralizes > 75% of the activity of 1 μg/mL of LMB-2 immunotoxin in tissue culture (due to either anti-toxin or anti-mouse immunoglobulin G antibodies)
No active graft-vs-host disease (i.e., off immunosuppression)

PRIOR CONCURRENT THERAPY:

Biologic therapy

Prior autologous bone marrow transplantation (BMT) allowed
At least 100 days since prior allogeneic BMT
At least 1 week since prior colony-stimulating factors (e.g., filgrastim [G-CSF], sargramostim [GM-CSF], or epoetin alfa)

Chemotherapy

At least 2 weeks since prior chemotherapy (4 weeks for nitrosoureas) except intrathecal chemotherapy
No other concurrent chemotherapy

Endocrine therapy

Concurrent corticosteroids allowed provided the dose has been stable for the past week and does not increase during study treatment

Tapering or discontinuation of steroids allowed

Radiotherapy

At least 3 weeks since prior radiotherapy unless < 10% of marrow is irradiated and measurable disease exists outside the radiation port

Surgery

Not specified

Other

Recovered from all prior therapy
At least 30 days since prior investigational agents
Concurrent oral supplementation to maintain normal electrolyte levels allowed
No concurrent anticoagulation therapy for disease-related conditions
No other concurrent investigational agents