Azacitidine in Treating Patients With Myelofibrosis

DISEASE CHARACTERISTICS:

Histologically confirmed myelofibrosis with myeloid metaplasia (MMM), including any of the following subtypes:

Agnogenic myeloid metaplasia
Post-polycythemic myeloid metaplasia
Post-thrombocythemic myeloid metaplasia

Evaluable and symptomatic disease, defined as 1 of the following:

Anemia (hemoglobin < 10 g/dL or erythrocyte transfusion-dependent, requiring 1 transfusion ≤ 8 weeks)
Treatment required* for symptomatic palpable splenomegaly (palpable hepatomegaly is acceptable if previously splenectomized) NOTE: *Subjective but painful enough to mandate intervention

Absence of t(9;22) by fluorescent in situ hybridization (FISH) or standard cytogenetics (by peripheral blood or marrow)

- Previous demonstration of a lack of this translocation (at any point) is sufficient

No advanced malignant hepatic tumors

PATIENT CHARACTERISTICS:

ECOG performance status 0-2
Absolute neutrophil count ≥ 1,000/mm³
Platelet count ≥ 50,000/mm³
Creatinine ≤ 2.0 mg/dL
Total bilirubin ≤ 2.0 mg/dL OR direct bilirubin ≤ 2.0 mg/dL if total bilirubin elevated (unless attributed to underlying disease)
AST and ALT ≤ 2 times upper limit of normal (unless clinically attributed to hepatic extramedullary hematopoiesis)
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No baseline peripheral or autonomic neuropathy ≥ grade 2
No condition, including the presence of laboratory abnormalities, that would preclude study compliance
No hypersensitivity to mannitol or azacitidine
Not incarcerated in a municipality (i.e., county, state, or federal prison)

PRIOR CONCURRENT THERAPY:

At least 14 days since prior chemotherapy, including interferon alfa, anagrelide, or other myelosuppressive agents
At least 14 days since prior systemic corticosteroids
At least 14 days since prior investigational agents