High-Dose Chemotherapy and Stem Cell Transplant in Treating Patients With Metastatic Germ Cell Tumors That Have Not Responded to First-Line Therapy

DISEASE CHARACTERISTICS:

* Histologically confirmed germ cell tumor (GCT) based on pathologic review at INT Milan

  * Metastatic disease
  * Relapsed or refractory disease
* Prior chemotherapy treatment for GCT without a pathologic diagnosis due to unequivocal clinical evidence of GCT and an urgent need to start therapy (elevated alpha-fetoprotein \[AFP\] or human chorionic gonadotropin \[HCG\] with pattern of metastases consistent with GCT and high tumor burden) allowed
* Unequivocal progression of measurable disease, consisting of abnormalities on 2-dimensional imaging or raised tumor markers, following 1 line of cisplatin-based chemotherapy as documented by either of the following:

  * Tumor biopsy of new, growing, or unresectable lesions demonstrating viable non-teratomatous GCT (enrollment on this study for adjuvant treatment after resection of viable GCT not allowed)
  * Increasing or abnormally elevated serum tumor markers (HCG or AFP) (increasing lactate dehydrogenase \[LDH\] alone does not constitute progressive disease)
* Received ≥ 3 and ≤ 6, cisplatin-based chemotherapy courses as part of first-line (initial) chemotherapy and ≤ 6 cisplatin-based chemotherapy courses
* Brain metastases allowed

  * May be treated with radiotherapy and/or surgery concurrently with cisplatin, ifosfamide, and etoposide regimen

    * Radiotherapy should not be given concurrently with mobilization phase/leukapheresis and high-dose carboplatin and etoposide

PATIENT CHARACTERISTICS:

* WBC ≥ 2,000/µL
* ANC ≥ 1,500/µL
* Platelet count ≥ 100,000/µL
* Creatinine clearance ≥ 50 cc/min (unless renal dysfunction is due to tumor obstructing the ureters, in which case eligibility will be determined by the principal investigator)
* AST/ALT \< 2 times upper limit of normal (ULN) (\< 5 times ULN if due to hepatic metastases)
* Total bilirubin \< 1.5 times ULN
* Ejection fraction ≥ 50% by echocardiogram
* Negative serology for the following infectious diseases:

  * HIV type 1 and 2
  * Hepatitis B surface antigen (active carriers)
  * Hepatitis C
  * Cytomegalovirus (serum Ag p65 ± PCR confirmation at principal investigator discretion)

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* Recovered from prior surgery
* At least 3 weeks since prior chemotherapy
* No prior high-dose chemotherapy with peripheral blood stem cell rescue
* No more than 1 prior chemotherapy regimen for metastatic disease