Combination Chemotherapy in Treating Patients With Myelodysplastic Syndrome

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed poor risk myelodysplastic syndrome, including at least one of the following:
• •* Bilineage cytopenia
• •* Unfavorable cytogenetic abnormalities
• •* Refractory anemia with excess blasts and/or refractory anemia with excess blast in transformation (greater than 5% blast)
• •At least 0.5 on the International Prognostic Score System
• •No chronic myelomonocytic leukemia
• •No hypocellular myelodysplastic syndrome (marrow cellularity less than 30%)
• •PATIENT CHARACTERISTICS:
• •Age:
• •16 and over
• •Performance status:
• •ECOG 0-1
• •Life expectancy:
• •Not specified
• •Hematopoietic:
• •Absolute neutrophil count less than 1,500/mm3
• •Platelet count less than 100,000/mm3
• •Hemoglobin less than 10 g/dL
• •Hepatic:
• •ALT less than 5 times upper limit of normal
• •Renal:
• •Creatinine no greater than 1.4 mg/dL
• •Cardiovascular:
• •No congestive heart failure
• •Other:
• •Not pregnant or nursing
• •Fertile patients must use effective contraception
• •Must have right atrial catheter inserted
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •No prior blood or bone marrow transplantations
• •Chemotherapy:
• •No prior acute myeloid leukemia chemotherapy (except hydroxyurea or low dose cytarabine)
• •No prior topotecan
• •No prior amifostine
• •Endocrine therapy:
• •Not specified
• •Radiotherapy:
• •Not specified
• •Surgery:
• •Not specified
• •Other:
• •At least 24 hours since prior antihypertensive medication prior to amifostine