Comparison of Three Treatment Regimens in Treating Patients With Relapsed or Refractory Acute Myelogenous Leukemia

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically proven acute myelogenous leukemia of one of the following types:
• * Acute myeloblastic leukemia (FAB type M0, M1, or M2)
• * Acute promyelocytic leukemia (FAB type M3) allowed if ineligible for an ECOG M3 protocol or if no tretinoin or arsenic trioxide therapy is planned
• * Acute myelomonocytic leukemia (FAB type M4)
• * Acute monocytic leukemia (FAB type M5)
• * Acute erythroleukemia (FAB type M6)
• * Acute megakaryocytic leukemia (FAB type M7)
• Must meet 1 of the following criteria:
• * Relapse less than 6 months after first complete remission (CR)
• * Relapse 6-12 months after first CR
• * Refractory to conventional initial induction chemotherapy (no more than 2 courses) or first reinduction (no more than 1 course)
• * Must have marrow documentation of residual leukemia after chemotherapy (for at least 2 weeks duration)
• * Second or greater relapse
• No relapse greater than 1 year after achieving first CR
• Blast cells must be CD33 positive
• Prior CNS leukemia allowed if there is currently documentation of no CNS involvement on CSF examination (i.e., negative CSF by lumbar puncture)
• PATIENT CHARACTERISTICS:
• Age:
• 18 and over
• Performance status:
• ECOG 0-2
• Life expectancy:
• Not specified
• Hematopoietic:
• See Disease Characteristics
• Hepatic:
• Bilirubin no greater than 2.0 mg/dL\*
• SGOT less than 2 times upper limit of normal\* NOTE: \*Unless due to leukemia infiltration
• Renal:
• Creatinine no greater than 2.0 mg/dL
• Cardiovascular:
• See Chemotherapy
• No myocardial infarction within the past 3 months
• No significant congestive heart failure
• No significant cardiac arrhythmia
• Cardiac ejection fraction normal by MUGA scan or echocardiogram
• Resting ejection fraction at least 50% or at least 5% increase with exercise
• Shortening fraction at least 24% or normal by echocardiogram
• Other:
• Not pregnant or nursing
• Fertile patients must use effective contraception
• No concurrent organ damage or other medical problems that would precludestudy therapy
• No concurrent evidence (including positive blood or deep tissue cultures or stains) of invasive fungal infection
• No hypersensitivity to ingredients of gemtuzumab ozogamicin or daunorubicin liposomal
• No other active tumor that would interfere with study therapy or increase risk
• PRIOR CONCURRENT THERAPY:
• Biologic therapy:
• No prior gemtuzumab ozogamicin
• Chemotherapy:
• See Disease Characteristics
• See Biologic therapy
• No prior daunorubicin liposomal or topotecan
• Prior doxorubicin (no greater than 300 mg/m2), daunorubicin (no greater than 300 mg/m2), idarubicin (no greater than 100 mg/m2), or mitoxantrone (no greater than 100 mg/m2) allowed if left ventricular function is adequate
• At least 4 weeks since prior chemotherapy except patients who are refractory to conventional initial induction chemotherapy
• Prior hydroxyurea allowed within 4 weeks prior to beginning study
• Hydroxyurea must be discontinued at least 24 hours prior to beginning study
• Endocrine therapy:
• Not specified
• Radiotherapy:
• At least 4 weeks since prior radiotherapy except patients who are refractory to conventional initial induction chemotherapy
• Surgery:
• Not specified