Azacitidine Plus Phenylbutyrate in Treating Patients With Acute Myeloid Leukemia or Myelodysplastic Syndrome

DISEASE CHARACTERISTICS:

Histologically or cytologically confirmed myelodysplastic syndrome (MDS) indicating one of the following:

Refractory anemia (RA)
Primary refractory leukopenia or thrombocytopenia with MDS morphology
RA with excess blasts (RAEB)
RA with ringed sideroblasts (RARS)
Chronic myelomonocytic leukemia
RAEB in transformation

RA or RARS must have at least one of the following:

Absolute neutrophil count less than 1,000/mm^3
Untransfused hemoglobin less than 8 g/dL
Platelet count less than 20,000/mm^3
Anemia
Thrombocytopenia requiring transfusion
High risk chromosomal abnormalities

Any stage of MDS allowed including:

Previously untreated MDS
Refractory MDS allowed if failure to achieve remission following prior intensive chemotherapy of at least 1 month ago

Relapsed, refractory, or untreated acute myeloid leukemia (AML) with the following:

WBC less than 30,000/mm^3
Stable for at least 2 weeks
Unlikely to require cytotoxic therapy during study

Untreated AML with poor risk factors for response to standard therapy including:

Greater than 60 years old
AML occurs in setting of antecedent hematologic disorder
High risk chromosomes (e.g., abnormalities of chromosome 5 or 7 or complex cytogenetic abnormalities)
Medical conditions that preclude cytotoxic chemotherapy as primary therapy
Refusal of cytotoxic chemotherapy allowed
No clinical evidence of CNS leukostasis or CNS leukemia

PATIENT CHARACTERISTICS:

Age:

18 and over

Performance status:

Zubrod 0-2

Life expectancy:

Not specified

Hematopoietic:

See Disease Characteristics
Hemoglobin at least 8 g/dL (transfusion allowed)

Hepatic:

Bilirubin less than 2.0 mg/dL (unless due to hemolysis or Gilbert's disease)

Renal:

Creatinine less than 2.0 mg/dL

Cardiovascular:

No disseminated intravascular coagulation

Pulmonary:

No pulmonary leukostasis

Other:

No active infection
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception 2 weeks prior, during and 3 months after study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

At least 3 weeks since prior biologic therapy including colony stimulating factors and recovered

Chemotherapy:

See Disease Characteristics
At least 3 weeks since prior chemotherapy and recovered

Endocrine therapy:

At least 3 weeks since prior hormonal therapy and recovered

Radiotherapy:

At least 3 weeks since prior radiotherapy and recovered

Surgery:

Not specified