Tipifarnib and Etoposide in Treating Older Patients With Newly Diagnosed, Previously Untreated Acute Myeloid Leukemia

Inclusion Criteria

• •Criteria:
• •Pathologically confirmed newly diagnosed acute myeloid leukemia (AML)
• •Subtypes M0, M1, M2, M4-7 disease
• •No newly diagnosed acute promyelocytic leukemia (M3)
• •Any of the following diseases:
• •De novo disease
• •Secondary AML
• •Myelodysplasia (MDS)-related AML (MDS/AML)
• •Treatment-related AML
• •Previously untreated disease
• •Patients who have received prior hydroxyurea alone or non-cytotoxic therapies for MDS (e.g., thalidomide, interferon, cytokines, 5-azacytidine, or revlimid) will be eligible for this study
• •Must be considered ineligible for traditional antileukemia chemotherapy
• •No hyperleukocytosis with ≥ 30,000 blasts/uL or rapidly rising blast count with projected doubling time of =\< 2 days
• •Patients may receive hydroxyurea to lower blast count to \< 30,000 blasts/uL up to 24 hours before beginning tipifarnib and etoposide
• •No active CNS leukemia
• •No prior tipifarnib or etoposide
• •No concurrent radiotherapy, immunotherapy, or other chemotherapy
• •No concurrent enzyme-inducing anticonvulsants (e.g., phenytoin, fosphenytoin, phenobarbital, primidone, carbamazepine, or oxcarbazepine)
• •Patients may be changed to non-enzyme-inducing anticonvulsants and stabilized before starting study treatment
• •ECOG performance status 0-2
• •Serum creatinine =\< 2.0 mg/dL
• •SGOT and SGPT =\< 3 times upper limit of normal
• •Bilirubin =\< 2 mg/dL