3RD GENERATION GD2 SPECIFIC CHIMERIC ANTIGEN RECEPTOR TRANSDUCED AUTOLOGOUS NATURAL KILLER T-CELLS FOR NEUROBLASTOMA

Procurement Inclusion Criteria:

* High risk neuroblastoma or persistent or relapsed disease
* Life expectancy of at least 12 weeks
* Age ≥1 and ≤18 years old
* Karnofsky/Lansky score of 60% or greater
* Absence of HAMA prior to enrollment (only in patients that have been previously treated with murine antibodies)
* Ability to tolerate leukocyte apheresis
* Informed consent for leukocyte apheresis
* Informed consent and assent (as applicable) obtained from parent/guardian and child.

Procurement Exclusion Criteria:

* Rapidly progressive disease
* History of hypersensitivity to murine protein containing products

Treatment Inclusion Criteria:

* High risk neuroblastoma with persistent or relapsed disease
* Life expectancy of at least 12 weeks
* Age ≥1 and ≤18 years old
* Karnofsky/Lansky score of 60% or greater
* Patients must have an ANC ≥ 500 without the use G-CSF or GM-CSF for at least 48hrs, platelet count ≥ 20,000
* Pulse Ox ≥ 90% on room air
* AST less than 5 times the upper limit of normal
* Bilirubin less than 3 times the upper limit of normal
* Serum creatinine less than 3 times upper limit of normal
* Recovered from the acute toxic effects of all prior chemotherapy (if some effects of chemotherapy are expected to last long term, patient is eligible if meeting other eligibility criteria).
* Absence of human anti-mouse antibodies (HAMA) prior to enrollment for patients who have received prior therapy with murine antibodies
* Patients must have autologous transduced NKTs with greater than or equal to 20% expression of GD2-specific CAR.
* Informed consent and assent (as applicable) obtained from parent/guardian and child.

Treatment Exclusion Criteria:

* Rapidly progressive disease
* Currently receiving other investigational drugs
* History of hypersensitivity to murine protein containing products
* History of cardiomegaly or bilateral pulmonary infiltrates on chest radiograph or CT. However, patients with cardiomegaly on imaging may be enrolled if they have an assessment of cardiac function (i.e., ECHO or MUGA) within 3 weeks of starting protocol therapy that is within normal limits. Additionally, patients with bilateral pulmonary infiltrates on imaging may be enrolled if the lesions are not consistent with active neuroblastoma (i.e., negative on functional imaging with PET or MIBG, or by pathologic assessment).
* Evidence of tumor potentially causing airway obstruction
* Patients who are pregnant, lactating, or unwilling to use birth control
* Patients currently receiving immunosuppressive drugs such as corticosteroids(Patients may receive treatment if treated with corticosteroids with dose of less than 0.5mg/kg/day of prednisone equivalent), tacrolimus or cyclosporine.
* Patients who have previously experienced severe toxicity from cyclophosphamide and fludarabine.

  * All labs must be collected within 10 days prior to initiation of study related treatment (except for verification of GD2 transduction)