Azacitidine in Treating Patients With Myelofibrosis

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed myelofibrosis with myeloid metaplasia (MMM), including any of the following subtypes:
• * Agnogenic myeloid metaplasia
• * Post-polycythemic myeloid metaplasia
• * Post-thrombocythemic myeloid metaplasia
• Evaluable and symptomatic disease, defined as 1 of the following:
• * Anemia (hemoglobin \< 10 g/dL or erythrocyte transfusion-dependent, requiring 1 transfusion ≤ 8 weeks)
• * Treatment required\* for symptomatic palpable splenomegaly (palpable hepatomegaly is acceptable if previously splenectomized) NOTE: \*Subjective but painful enough to mandate intervention
• Absence of t(9;22) by fluorescent in situ hybridization (FISH) or standard cytogenetics (by peripheral blood or marrow)
• \- Previous demonstration of a lack of this translocation (at any point) is sufficient
• No advanced malignant hepatic tumors
• PATIENT CHARACTERISTICS:
• ECOG performance status 0-2
• Absolute neutrophil count ≥ 1,000/mm³
• Platelet count ≥ 50,000/mm³
• Creatinine ≤ 2.0 mg/dL
• Total bilirubin ≤ 2.0 mg/dL OR direct bilirubin ≤ 2.0 mg/dL if total bilirubin elevated (unless attributed to underlying disease)
• AST and ALT ≤ 2 times upper limit of normal (unless clinically attributed to hepatic extramedullary hematopoiesis)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No baseline peripheral or autonomic neuropathy ≥ grade 2
• No condition, including the presence of laboratory abnormalities, that would preclude study compliance
• No hypersensitivity to mannitol or azacitidine
• Not incarcerated in a municipality (i.e., county, state, or federal prison)
• PRIOR CONCURRENT THERAPY:
• At least 14 days since prior chemotherapy, including interferon alfa, anagrelide, or other myelosuppressive agents
• At least 14 days since prior systemic corticosteroids
• At least 14 days since prior investigational agents