Pyrazoloacridine and Stem Cell or Bone Marrow Transplantation in Treating Young Patients With High-Risk Neuroblastoma

PRIMARY OBJECTIVES: I. To determine the maximum tolerated dose (MTD) of PZA given as a single prolonged infusion (\>= 6 hours) with autologous hematopoietic stem cell (aHSC) support to children with high risk neuroblastoma with recurrent or refractory disease. II. To determine the dose limiting toxicity (DLT) of PZA given on this schedule. III. To characterize the pharmacokinetics of PZA given on this schedule. SECONDARY OBJECTIVES: I. To obtain preliminary data on the antitumor activity of PZA within the confines of a Phase I study. II. To determine the TP53 mutation status of tumor cells in bone marrow if \> 10% are present; to evaluate expression of p53 and MDM2 proteins by flow cytometry if \>= 0.1% to \< 10% are present at study entry. OUTLINE: This is a two-stage, dose-escalation study. Patients without adequate cryopreserved hematopoietic stem cells undergo peripheral blood stem cell harvest or bone marrow harvest for autologous stem cells at least 2 weeks before study therapy. Patients receive high-dose pyrazoloacridine (PZA) IV on day 0. Cohort 1: Groups of 3-6 patients receive escalating doses of PZA at a fixed infusion time until the maximum tolerated dose (MTD) is determined. Cohort 2: Groups of 3-6 patients receive PZA at the dose/hour established in cohort I at escalating infusion times until another MTD is determined. In both cohorts the MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Patients receive filgrastim (G-CSF) IV or subcutaneously beginning on day 4 and continuing until blood counts recover. Patients also undergo reinfusion of stem cells over 15-30 minutes on day 4 as needed per protocol. Patients are followed at days 28-35, every 3 months for 3 years, and then every 6 months thereafter.