Comparison of Three Treatment Regimens in Treating Patients With Relapsed or Refractory Acute Myelogenous Leukemia

DISEASE CHARACTERISTICS:

Histologically proven acute myelogenous leukemia of one of the following types:

Acute myeloblastic leukemia (FAB type M0, M1, or M2)
Acute promyelocytic leukemia (FAB type M3) allowed if ineligible for an ECOG M3 protocol or if no tretinoin or arsenic trioxide therapy is planned
Acute myelomonocytic leukemia (FAB type M4)
Acute monocytic leukemia (FAB type M5)
Acute erythroleukemia (FAB type M6)
Acute megakaryocytic leukemia (FAB type M7)

Must meet 1 of the following criteria:

Relapse less than 6 months after first complete remission (CR)
Relapse 6-12 months after first CR

Refractory to conventional initial induction chemotherapy (no more than 2 courses) or first reinduction (no more than 1 course)

Must have marrow documentation of residual leukemia after chemotherapy (for at least 2 weeks duration)
Second or greater relapse
No relapse greater than 1 year after achieving first CR
Blast cells must be CD33 positive
Prior CNS leukemia allowed if there is currently documentation of no CNS involvement on CSF examination (i.e., negative CSF by lumbar puncture)

PATIENT CHARACTERISTICS:

Age:

18 and over

Performance status:

ECOG 0-2

Life expectancy:

Not specified

Hematopoietic:

See Disease Characteristics

Hepatic:

Bilirubin no greater than 2.0 mg/dL*
SGOT less than 2 times upper limit of normal* NOTE: *Unless due to leukemia infiltration

Renal:

Creatinine no greater than 2.0 mg/dL

Cardiovascular:

See Chemotherapy
No myocardial infarction within the past 3 months
No significant congestive heart failure
No significant cardiac arrhythmia
Cardiac ejection fraction normal by MUGA scan or echocardiogram
Resting ejection fraction at least 50% or at least 5% increase with exercise
Shortening fraction at least 24% or normal by echocardiogram

Other:

Not pregnant or nursing
Fertile patients must use effective contraception
No concurrent organ damage or other medical problems that would precludestudy therapy
No concurrent evidence (including positive blood or deep tissue cultures or stains) of invasive fungal infection
No hypersensitivity to ingredients of gemtuzumab ozogamicin or daunorubicin liposomal
No other active tumor that would interfere with study therapy or increase risk

PRIOR CONCURRENT THERAPY:

Biologic therapy:

No prior gemtuzumab ozogamicin

Chemotherapy:

See Disease Characteristics
See Biologic therapy
No prior daunorubicin liposomal or topotecan
Prior doxorubicin (no greater than 300 mg/m2), daunorubicin (no greater than 300 mg/m2), idarubicin (no greater than 100 mg/m2), or mitoxantrone (no greater than 100 mg/m2) allowed if left ventricular function is adequate
At least 4 weeks since prior chemotherapy except patients who are refractory to conventional initial induction chemotherapy
Prior hydroxyurea allowed within 4 weeks prior to beginning study
Hydroxyurea must be discontinued at least 24 hours prior to beginning study

Endocrine therapy:

Not specified

Radiotherapy:

At least 4 weeks since prior radiotherapy except patients who are refractory to conventional initial induction chemotherapy

Surgery:

Not specified