Topotecan in Treating Young Patients With Neoplastic Meningitis Due to Leukemia, Lymphoma, or Solid Tumors

You may be eligible if

• DISEASE CHARACTERISTICS:
• Diagnosis of neoplastic meningitis secondary to leukemia, lymphoma (including AIDS-related lymphoma), or solid tumor (including primary CNS tumors or carcinomas of unknown primary site), defined by 1 of the following criteria:
• * Cerebral spinal fluid (CSF) cell count \> 5/μL AND evidence of blast cells on cytospin or by cytology (for patients with leukemia or lymphoma)
• * Presence of tumor cells on cytospin or cytology OR unequivocal presence of meningeal disease by MRI (for patients with solid tumor)
• No conventional therapy for neoplastic meningitis exists
• * Patients with CNS leukemia or lymphoma must be refractory to conventional therapy, including radiotherapy (i.e., second or greater relapse)
• Patients with CNS leukemia or lymphoma must have had a negative bone marrow aspiration within the past 2 weeks
• No clinical evidence of obstructive hydrocephalus
• No compartmentalization of CSF flow by radioisotope indium In 111 or technetium Tc 99 DTPA flow study
• No ventriculoperitoneal or ventriculoatrial shunt unless patient is completely shunt-independent
• No impending spinal cord compression or other CNS involvement (e.g., acute visual loss secondary to optic nerve involvement) requiring emergent local radiotherapy
• PATIENT CHARACTERISTICS:
• Age
• 3 to 21
• Performance status
• Lansky 60-100% (≤ 16 years of age) OR
• Karnofsky 60-100% (\> 16 years of age)
• Life expectancy
• Not specified
• Hematopoietic
• Not specified
• Hepatic
• Not specified
• Renal
• Calcium ≥ 7 mg/dL
• Other
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Sodium 125-150 mmol/L
• Magnesium ≥ 0.7 mmol/L
• Must have or be willing to have an intraventricular access device (i.e., Ommaya reservoir)
• No uncontrolled infection
• * HIV-positive patients with AIDS-related lymphomatous meningitis are eligible
• No other significant uncontrolled systemic medical illness that would preclude study participation
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• Recovered from prior biologic therapy or immunotherapy
• Chemotherapy
• Recovered from prior chemotherapy
• At least 1 week since prior intra-colony stimulating factory (CSF) chemotherapy (2 weeks for liposomal cytarabine)
• At least 3 weeks since prior systemic chemotherapy for leptomeningeal disease
• Concurrent systemic chemotherapy to control systemic disease or bulk CNS disease allowed provided the systemic chemotherapy is not an investigational agent OR any of the following:
• * High-dose (\> 1 g/m\^2) methotrexate
• * High-dose (\> 1 g/m\^2) cytarabine
• * Fluorouracil
• * Capecitabine
• * Thiotepa
• * Nitrosoureas
• * Topotecan
• Endocrine therapy
• Not specified
• Radiotherapy
• See Disease Characteristics
• At least 8 weeks since prior craniospinal radiotherapy and recovered
• No concurrent CNS radiotherapy
• * Concurrent radiotherapy to extra-CNS sites (e.g., painful bone metastases not in the craniospinal axis) allowed
• Surgery
• Not specified
• Other
• More than 2 weeks since prior and no other concurrent investigational agents
• No other concurrent intra-CSF or systemic therapy for leptomeningeal disease