Tipifarnib and Etoposide in Treating Older Patients With Newly Diagnosed, Previously Untreated Acute Myeloid Leukemia

Criteria:

Pathologically confirmed newly diagnosed acute myeloid leukemia (AML)
Subtypes M0, M1, M2, M4-7 disease
No newly diagnosed acute promyelocytic leukemia (M3)
Any of the following diseases:
De novo disease
Secondary AML
Myelodysplasia (MDS)-related AML (MDS/AML)
Treatment-related AML
Previously untreated disease
Patients who have received prior hydroxyurea alone or non-cytotoxic therapies for MDS (e.g., thalidomide, interferon, cytokines, 5-azacytidine, or revlimid) will be eligible for this study
Must be considered ineligible for traditional antileukemia chemotherapy
No hyperleukocytosis with ≥ 30,000 blasts/uL or rapidly rising blast count with projected doubling time of =< 2 days
Patients may receive hydroxyurea to lower blast count to < 30,000 blasts/uL up to 24 hours before beginning tipifarnib and etoposide
No active CNS leukemia
No prior tipifarnib or etoposide
No concurrent radiotherapy, immunotherapy, or other chemotherapy
No concurrent enzyme-inducing anticonvulsants (e.g., phenytoin, fosphenytoin, phenobarbital, primidone, carbamazepine, or oxcarbazepine)
Patients may be changed to non-enzyme-inducing anticonvulsants and stabilized before starting study treatment

Inclusion Criteria:

ECOG performance status 0-2
Serum creatinine =< 2.0 mg/dL
SGOT and SGPT =< 3 times upper limit of normal
Bilirubin =< 2 mg/dL

Exclusion Criteria:

Active, uncontrolled infection
Patients with infection under active treatment and controlled with antimicrobials are eligible
Presence of other life-threatening illnesses
Patients with mental deficits and/or psychiatric history that preclude them from giving informed consent or from following protocol
Allergies to imidazoles (e.g., clotrimazole, ketoconazole, miconazole, or econazole)