Iodine I 131 Metaiodobenzylguanidine in Treating Patients With Recurrent, Progressive, or Refractory Neuroblastoma or Malignant Pheochromocytoma or Paraganglioma

Inclusion criteria for NB:

- Patients must have the diagnosis of NB in accordance with the International Criteria,
i.e., either histopathology (confirmed by the MSKCC Department of Pathology) or BM
involvement plus elevated urinary catecholamines.

- Must have a history of tumor progression or recurrence or failure to achieve complete
response with standard therapy.

- Patients must have MIBG-avid NB and evaluable disease on MIBG scan at time of
enrollment on protocol

- Prior Therapy: At least 2 weeks should have elapsed since any biologic therapy. Three
weeks should have elapsed since last dose of chemotherapy.

- Age >1 year with a determination that radiation safety restrictions during therapy
period can be implemented.

- Stem cells: Patients must have an autologous hematopoietic stem cell product
cryopreserved and available for re-infusion after MIBG treatment. The minimum dose for
peripheral blood stem cells is 2 X106 CD34+ cells/kg.

- Minimum life expectancy of eight weeks

- Signed informed consent indicating awareness of the investigational nature of this
program.

Inclusion criteria for malignant CCT:

- Patients must have the diagnosis of malignant CCT i.e. malignant pheochromocytoma or
malignant paraganglioma

- Patients must have MIBG-avid malignant CCT and evaluable disease on MIBG scan at time
of enrollment on protocol

- Prior Therapy: At least 2 weeks should have elapsed since any biologic therapy. Three
weeks should have elapsed since last dose of chemotherapy.

- Age between 1 and 21 years and able to cooperate with radiation safety restrictions
during therapy period

- Stem cells: Patients must have an autologous hematopoietic stem cell product
cryopreserved and available for re-infusion after MIBG treatment. The minimum dose for
peripheral blood stem cells is 2 X106 CD34+ cells/kg.

- Minimum life expectancy of eight weeks.

- Signed informed consent indicating awareness of the investigational nature of this
program.

Exclusion Criteria:

- Severe major organ toxicity. Specifically, renal, cardiac, hepatic, pulmonary,
gastrointestinal and neurologic toxicity should all be grade 2 or less. A grade 3
hearing deficit is acceptable.

- Active serious infections not controlled by antibiotics.

- Pregnant women are excluded for fear of danger to the fetus. Therefore negative
pregnancy test is required for all women of child-bearing age, and appropriate
contraception is used during the study period.

- Inability or unwillingness to comply with radiation safety procedures or protocol
requirements.