Donor Natural Killer Cells, Cyclophosphamide, and Etoposide in Treating Children and Young Adults with Relapsed or Refractory Solid Tumors

Inclusion Criteria

• SCREENING: Patient age between 12 months and 40 years, inclusive at the time of study entry.
• SCREENING: Patients with relapsed or refractory solid tumors and without known curative therapy or therapy proven to proven to prolong survival with acceptable quality of life.
• SCREENING: Patients older than 21 years must have a solid tumor considered by study doctor to be of the childhood cancer type.
• SCREENING: Performance level as measured by Karnofsky >= 60% for patients > 16 years of age or Lansky >= 60% for patients =< 16 years of age.
• SCREENING: Documentation of measurable or evaluable non-measurable disease.
• SCREENING: At least one documented histological verification of solid tumor diagnosis. Can be from original diagnosis or more recent.
• ENROLLMENT: Patient must have fully recovered (i.e. returned to baseline) from the clinically significant acute treatment-related toxicities of all prior treatments prior to beginning treatment on this protocol with exceptions of cytopenias resulting from persistent disease, hearing loss and alopecia.
• ENROLLMENT: Performance level as measured by Karnofsky >= 60% for patients > 16 years of age or Lansky >= 60% for patients =< 16 years of age.
• ENROLLMENT: Creatinine clearance >= 60 mL/min/1.73m^2 (calculated by 24 hour [h] urine collection or nuclear glomerular filtration rate [GFR] scan if 24 h collection is not possible) or a serum creatinine based on age and gender as follows: * Age, maximum serum creatinine (mg/dL): ** 1 month to < 6 months, male 0.4, female 0.4; ** 6 months to < 1 year, male 0.5, female 0.5; ** 1 to < 2 years, male 0.6, female 0.6; ** 2 to < 6 years, male 0.8, female 0.8; ** 6 to < 10 years, male 1, female 1; ** 10 to < 13 years, male 1.2, female 1.2; ** 13 to < 16 years, male 1.5, female 1.4; ** >= 16 years, male 1.7, female 1.4.
• ENROLLMENT: Adequate liver function, defined as: total bilirubin =< 2 mg/dl and serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 2.5 x upper limit of normal (ULN) for age (unless Gilbert’s disease or abnormal liver function due to primary disease)
• ENROLLMENT: Evidence of adequate bone marrow function (defined by absolute neutrophil count >= 750), unless patient has documented tumor metastasis to the bone marrow or other condition that results in cytopenia without abnormal marrow function.
• ENROLLMENT: Evidence of adequate bone marrow function (defined by platelets >= 50,000), unless patient has documented tumor metastasis to the bone marrow or other condition that results in cytopenia without abnormal marrow function.
• ENROLLMENT: Pulmonary symptoms controlled by medication and pulse oximetry >= 92% on room air.
• ENROLLMENT: Sexually active males and females of childbearing potential must agree to use a form of contraception considered effective and medically acceptable by the investigator. (Non-childbearing potential defined as pre-menarche, greater than one year post-menopausal or surgically sterilized).
• ENROLLMENT: Confirmation that a cord blood donor which is matched with the recipient at a 4, 5, or 6/6 human leukocyte antigen (HLA) class I (serological) and HLA class II (molecular) antigens.
• ENROLLMENT: Patients with a prior history of hypersensitivity to etoposide are eligible.
• ENROLLMENT: Signed informed consent and if applicable pediatric assent.

Exclusion Criteria

• SCREENING: Primary tumors of the central nervous system.
• SCREENING: Chronic corticosteroid dependence that is unable to be weaned to discontinue.
• SCREENING: Determined by study doctor that patient is unlikely to meet inclusion criteria after screening.
• ENROLLMENT: Uncontrolled arrhythmias or uncontrolled symptoms of cardiac disease noted by screening history and physical. Patients with known cardiac dysfunction should have an ejection fraction (EF) > 40% documented by echocardiogram (ECHO).
• ENROLLMENT: Patients where the burden of pulmonary metastasis, location, or bulkiness of disease may cause high morbidity if localized swelling such as causing uncontrolled symptoms, oxygen dependence, or location near a major bronchi as determined by investigator.
• ENROLLMENT: Pregnant females.
• ENROLLMENT: Any uncontrolled systemic infection.