MS-275 in Treating Patients With Hematologic Cancer

DISEASE CHARACTERISTICS:

One of the following histologically confirmed diagnoses:

Acute myeloid leukemia (AML)

Newly diagnosed de novo AML in patients over 60 years old with the following poor-risk features:

Antecedent hematologic disorder
Complex karyotype or other adverse cytogenetics
Stem cell immunophenotype
AML arising from myelodysplastic syndromes (MDS)
Secondary AML
Relapsed or refractory AML, including primary induction failure

MDS

Poor-risk, defined as the following:

International Performance Score at least 1.5
More than 10% marrow blasts
Cytopenias in at least 2 lineages
Refractory anemia with excess blasts (RAEB)
RAEB in transformation
Chronic myelomonocytic leukemia

Acute lymphoblastic leukemia (ALL)

Newly diagnosed de novo ALL in patients over 60 years old with the following poor-risk features:

Complex karyotype or other adverse cytogenetics
Mixed lineage immunophenotype
Relapsed or refractory ALL, including primary induction failure

Chronic myelogenous leukemia (CML)

CML in accelerated phase or blast crisis
Interferon-refractory CML in chronic phase

Multiple myeloma (MM)

Relapsed or refractory, including prior autologous stem cell transplantation

Acute promyelocytic leukemia

Prior treatment with tretinoin
Ineligible for arsenic trioxide
No evidence of active coagulopathy

Low-risk for developing clinically significant coagulopathy during study

Low tumor burden by marrow aspiration at time of relapse
No prior coagulation-related sequelae (deep vein thrombosis, pulmonary embolism, or CNS thrombosis or bleed)
Failure after primary induction therapy or relapse after complete remission allowed if patient received no more than 3 courses of prior induction/reinduction therapy
Not eligible for curative stem cell transplantation
No hyperleukocytosis with at least 50,000/mm^3 leukemic blasts
No active CNS leukemia
No plasma cell leukemia
No amyloidosis resulting in major organ dysfunction

PATIENT CHARACTERISTICS:

Age:

18 and over

Performance status:

ECOG 0-2

Life expectancy:

Not specified

Hematopoietic:

See Disease Characteristics
No disseminated intravascular coagulation
No hyperviscosity

Hepatic:

AST/ALT no greater than 2 times normal
Alkaline phosphatase no greater than 2 times normal
Bilirubin no greater than 1.5 times normal

Renal:

Creatinine no greater than 1.5 times normal
No uncorrected hypercalcemia

Cardiovascular:

See Disease Characteristics
LVEF at least 45% by MUGA or echocardiogram

No intrinsic impaired cardiac function, including any of the following:

Myocardial infarction within the past 3 months
Prior severe coronary artery disease
Cardiomyopathy
Congestive heart failure

Other:

No active uncontrolled infection
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

See Disease Characteristics
At least 1 week since prior growth factors (epoetin alfa, filgrastim [G-CSF], sargramostim [GM-CSF], interleukin [IL]-3, or IL-11)
At least 4 weeks since prior autologous stem cell transplantation
No prior allogeneic stem cell transplantation
No concurrent immunotherapy

Chemotherapy:

See Disease Characteristics
At least 3 weeks since prior chemotherapy and recovered
At least 24 hours since prior hydroxyurea or mercaptopurine for prevention of leukostasis
No concurrent chemotherapy

Endocrine therapy:

Not specified

Radiotherapy:

At least 2 weeks since prior emergency radiotherapy to large soft tissue or lytic bony lesions for MM
No concurrent radiotherapy

Surgery:

Not specified

Other:

At least 24 hours since other prior noncytotoxic agents for prevention of leukostasis
No other concurrent antitumor therapy