3-AP Followed By Fludarabine In Treating Patients With Relapsed or Refractory Acute or Chronic Leukemia or High-Risk Myelodysplastic Syndrome

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed diagnosis of 1 of the following:
• * High-risk myelodysplastic syndromes (MDS), including refractory anemia with excess blasts and chronic myelomonocytic leukemia
• * International Prognostic Scoring System (IPSS) score at least 1.5 based on the following:
• * More than 10% marrow blasts
• * Cytopenias in at least 2 lineages
• * Adverse cytogenetics
• * Acute myeloid leukemia (AML)
• * All subtypes, including MDS/AML and treatment-related (secondary) AML
• * Acute lymphoblastic leukemia
• * Acute progranulocytic leukemia
• * Ineligible for arsenic therapy
• * Chronic myelogenous leukemia
• * Accelerated phase or blastic crisis
• * Chronic lymphocytic leukemia
• * Prolymphocytic leukemia
• Received or ineligible for established curative regimens, including stem cell transplantation
• Acute and chronic leukemias must be relapsed and/or refractory with progressive disease since last therapy
• PATIENT CHARACTERISTICS:
• Age
• 18 and over
• Performance status
• ECOG 0-2
• Life expectancy
• Not specified
• Hematopoietic
• No history of hemolytic anemia grade 2 or greater
• No known glucose-6-phosphate dehydrogenase (G6PD) deficiency
• * G6PD screening required for high-risk groups (i.e., patients of African, Asian, or Mediterranean origin/ancestry)
• Hepatic
• SGOT and SGPT no greater than 2.5 times normal
• Bilirubin no greater than 2 mg/dL
• No chronic hepatitis
• Renal
• Creatinine normal OR
• Creatinine clearance at least 60 mL/min
• Cardiovascular
• No active heart disease
• No myocardial infarction within the past 3 months
• No severe coronary artery disease
• No arrhythmias (other than atrial flutter or fibrillation) requiring medication
• No uncontrolled congestive heart failure
• Pulmonary
• No dyspnea at rest or with minimal exertion
• No severe pulmonary disease requiring supplemental oxygen
• Other
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No neuropathy grade 2 or greater
• No active uncontrolled infection
• * Infections under active treatment and controlled by antibiotics are allowed
• No other life-threatening illness
• No psychiatric illness that would preclude study compliance
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• See Disease Characteristics
• At least 1 week since prior hematopoietic growth factor (e.g., epoetin alfa, filgrastim \[G-CSF\], sargramostim \[GM-CSF\], interleukin-3, and interleukin-11)
• No concurrent immunotherapy
• Chemotherapy
• Recovered from prior chemotherapy (no greater than grade 1 chronic toxic effects)
• At least 72 hours since prior hydroxyurea
• At least 3 weeks since prior myelosuppressive cytotoxic agents (6 weeks for mitomycin or nitrosoureas)
• No more than 12 prior courses of fludarabine
• No more than 3 prior cytotoxic chemotherapy regimens
• No other concurrent chemotherapy
• Endocrine therapy
• Not specified
• Radiotherapy
• At least 2 weeks since prior radiotherapy
• No concurrent radiotherapy
• Surgery
• Not specified
• Other
• At least 1 week since prior non-myelosuppressive treatment
• No more than 4 prior induction regimens
• No other concurrent therapy