Decitabine in Treating Children With Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia

You may be eligible if

• Histologically confirmed acute myeloid leukemia (AML) or acute lymphoblastic leukemia that is considered refractory to conventional therapy or for which no conventional therapy exists
• For patients with AML:
• * M3 marrow
• * M2 marrow with at least 15% blasts
• * Secondary AML allowed
• CNS involvement allowed
• Performance status - Karnofsky 50-100% (age 17 to 21)
• Performance status - Lansky 50-100% (age 16 and under)
• At least 8 weeks
• See Chemotherapy
• WBC no greater than 30,000/mm\^3
• Patients with granulocytopenia, anemia, and/or thrombocytopenia are eligible but are not evaluable for hematological toxicity
• Bilirubin no greater than 1.5 times normal
• ALT no greater than 5 times normal
• Albumin at least 2 g/dL
• Creatinine no greater than 1.5 times normal
• Creatinine clearance or radioisotope glomerular filtration rate at least lower limit of normal
• Shortening fraction at least 27% by echocardiogram
• Ejection fraction at least 50% by MUGA scan
• No evidence of dyspnea at rest
• No exercise intolerance
• Oxygen saturation greater than 94% by pulse oximetry
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Concurrent seizure disorder allowed if well controlled on anticonvulsants
• No grade 2 or greater CNS toxicity
• No uncontrolled infection (i.e., infections associated with fever, dissemination, hemodynamic instability \[requiring pressor support\], and progression while on therapy)
• No active graft-versus-host disease (GVHD)
• * GVHD well controlled on cyclosporine allowed
• Recovered from prior immunotherapy
• At least 1 week since prior biologic agents
• At least 6 months since prior allogeneic bone marrow transplantation (BMT)
• At least 3 months since prior autologous BMT
• No concurrent sargramostim (GM-CSF)
• No concurrent prophylactic filgrastim (G-CSF) during the first course of therapy
• Recovered from prior chemotherapy
• At least 4 weeks since prior cytarabine
• At least 24 hours since prior cytoreductive therapy with hydroxyurea (20-30 mg/kg/day for no more than 7 days) to lower the WBC to no greater than 30,000/mm\^3
• No concurrent intrathecal therapy during the first course of decitabine
• Recovered from prior radiotherapy
• At least 2 weeks since prior local palliative radiotherapy (small port)
• At least 6 weeks since prior cranial or craniospinal radiotherapy
• No concurrent medications that induce cytidine deaminase or deoxycytidine kinase (e.g., cytarabine)
• No concurrent medications that mask poor or deteriorating organ function
• No concurrent CNS prophylaxis during the first course of decitabine
• Concurrent anticonvulsants with no known interactions with decitabine allowed
• Concurrent antibacterial or antifungal therapies for controlled infections allowed