OBJECTIVES:

        -  To assess whether sufficient peripheral blood stem cells (PBSC) can be collected from
           patients with acute myeloid leukemia (AML) using cyclophosphamide, etoposide, and
           granulocyte-colony stimulating factor (G-CSF) mobilization.

        -  To assess the rate of myeloid, platelet, and erythroid recovery following autologous
           PBSC transplant.

        -  To assess the disease-free survival rate of patients with AML receiving PBSC auto
           grafts.

      OUTLINE:

        -  Chemotherapy and filgrastim (G-CSF) priming for PBSC collection: Patients receive
           cyclophosphamide IV on day 0; etoposide IV over 3 hours on days 0 and 1; and oral
           dexamethasone twice daily on days 0 and 1. Patients also receive G-CSF subcutaneously
           (SC) beginning on day 3 and continuing until apheresis is complete. After blood counts
           recover, apheresis is performed in 4-6 daily planned collections until the minimum CD34+
           cell dose of > 2.5 x 10^6 cells/kg is achieved. If the minimum CD34+ cell dose is not
           achieved after 6 apheresis collections, patients undergo bone marrow examination
           including a bone marrow biopsy and aspiration, at the termination of the PBSC collection
           to confirm remission. If remission is confirmed, and if peripheral counts and marrow
           cellularity are sufficient, the patient remains off G-CSF for 7 days and receives
           sargramostim (GM-CSF) for 5 days to increase the marrow cellularity, after which a bone
           marrow harvest is performed.

        -  Bone marrow harvest without prior PBSC collection: Children will undergo primed bone
           marrow harvest comprising GM-CSF IV or SC for 5 days prior to harvest to increase
           cellularity and then marrow is harvested. Marrow and blood specimens are also obtained
           with the initial bone marrow evaluation and at the time of harvest if a cytogenetic
           abnormality was previously described. Other patients who are unable to undergo PBSC
           collection may proceed with a bone harvest at the discretion of the protocol
           chairperson.

        -  Cytoreductive regimen:

             -  Patients over 2 years old: Patients undergo total body irradiation (TBI) twice
                daily on days -7 to -4 (total of 8 fractions), cyclophosphamide IV over 2 hours on
                days -3 and -2, followed by a 1-day rest period on day -1.

             -  Patients under 2 years old and patients who cannot undergo TBI: Patients receive
                busulfan IV or orally every 6 hours on days -7 to -4, cyclophosphamide IV over 2
                hours on days -3 to -2, followed by a 1-day rest period on day -1.

        -  Stem cell transplantation: All patients undergo autologous PBSC and/or bone marrow
           infusion on day 0. Patients also receive G-CSF IV or SC beginning on day 1 and
           continuing until blood counts recover.

      After completion of study treatment, patients are followed periodically for 5 years.