Combination Chemotherapy Plus PSC-833 in Treating Children With Refractory or Relapsed Acute Leukemia

You may be eligible if

• DISEASE CHARACTERISTICS:
• Acute myeloid leukemia (AML) in one of the following categories:
• First relapse if initial CR less than 6 months
• Refractory to first or second induction with daunomycin, cytarabine, and thioguanine (DAT) or other anthracycline-containing regimens
• Relapse following bone marrow transplantation provided good trilineage engraftment followed transplant and greater than 6 months since transplant
• Presentation with secondary AML or AML evolving from myelodysplastic syndrome --Acute lymphocytic leukemia in one of the following categories:
• In second or subsequent relapse or failed second or later induction attempts regardless of prior remissions
• Relapsed following bone marrow transplantation provided good trilineage engraftment followed transplant and greater than 6 months since transplant
• No isolated CNS or extramedullary relapse
• PATIENT CHARACTERISTICS:
• Age: Under 22 at diagnosis
• Performance status: Karnofsky 50-100% (ECOG 0-2)
• Lansky 40-100% (in patients under 12 years of age)
• Life expectancy: At least 8 weeks
• Bilirubin less than 1.5 mg/dL
• ALT less than twice normal
• Creatinine normal for age (within 2 standard deviations) OR glomular filtration rate at least 70 mL/min
• Albumin at least 3 g/dL
• Ejection fraction greater than 50% at rest or with 5% increase with exercise OR shortening fraction greater than 27% by echocardiogram
• No history of clinical heart failure
• No uncontrolled infection
• No anticonvulsant therapy
• No history of allergic reactions or anaphylaxis to etoposide not remediable by premedication
• Not pregnant or nursing
• Fertile patients must use effective contraception
• Third percentile weight for height
• PRIOR CONCURRENT THERAPY:
• At least 4 weeks since chemotherapy and recovered
• Prior cumulative anthracycline dose no greater than 360 mg per square meter
• Hydroxyurea therapy allowed just prior to study for rapidly rising blast count