Gemcitabine and Hodgkin's Disease Chemotherapy Followed by Peripheral Blood Stem Cell Rescue for Hodgkin's Disease

Inclusion Criteria

• Histologically-proven recurrent or refractory Hodgkin's Disease (Hodgkin's lymphoma) on the basis of excisional biopsy whenever possible.
• Age 75% reduction in a bulky tumor mass and bone marrow involvement 60 cc/min by the following formula (within 28 days prior to registration):
• Estimated Creatinine Clearance = (140 age) x WT(kg) x 0.85 (if female) x creatinine (mg/dL)
• Electrocardiogram (ECG) demonstrating no significant abnormalities suggestive of active cardiac disease (within 42 days prior to registration)
• Patients over age 50, who have received chest irradiation or a total of 300 mg/m2 of doxorubicin or with any history of cardiac disease must have a radionuclide ejection fraction (within 42 days prior to registration). If the ejection fraction is 40 to 50%, the patient will have a cardiology consult
• Corrected diffusion capacity > 55%
• Written informed consent in accordance with institutional and federal guidelines

Exclusion Criteria

• Positive HIV antibody test (must be conducted within 42 days of registration)
• No chemotherapy other than corticosteroids should be administered within 2 weeks of the initiation of protocol therapy
• Pregnant
• Breast-feeding
• Requiring therapy for:
• Coronary artery disease
• Cardiomyopathy
• Dysrhythmia, or
• Congestive heart failure
• Over age 50 and has received chest irradiation or a total of 300 mg/m^2 of doxorubicin
• History of cardiac disease and the ejection fraction is < 40% (radionuclide ejection fraction must be within 42 days of registration)
• Known allergy to etoposide
• History of Grade 3 hemorrhagic cystitis with cyclophosphamide
• History of grade 2 or greater sensory or motor peripheral neuropathy due to prior vinca alkaloid use
• No prior malignancy (EXCEPTION: adequately treated basal cell or squamous cell skin cancer; in situ cervical cancer; or other cancer for which the patients has been disease-free for 5 years). Patients with a prior diagnosis of non-Hodgkin's lymphoma are not eligible.