RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
so they stop growing or die. Bone marrow transplantation may be able to replace immune cells
that were destroyed by chemotherapy used to kill cancer cells.
PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy followed by
G-CSF and peripheral stem cell transplantation in treating patients with chronic myelogenous
OBJECTIVES: I. Evaluate the efficacy of MCE (mitoxantrone/cytarabine/etoposide) followed by
granulocyte colony-stimulating factor to mobilize peripheral blood stem cells (PBSC) in
patients with chronic myeloid leukemia (CML). II. Evaluate the toxicity of this regimen.
III. Evaluate the cytoreductive effects of this regimen in CML as determined by the ability
to mobilize Philadelphia chromosome-negative PBSC. IV. Assess the time of peak CD34+ and
CD34+/CD38- cell concentrations in the peripheral blood of patients treated with this
OUTLINE: The following acronyms are used: ARA-C Cytarabine, NSC-63878 DHAD Mitoxantrone,
NSC-301739 G-CSF Granulocyte Colony-Stimulating Factor (source not specified) HU
Hydroxyurea, NSC-32065 MCE DHAD/ARA-C/VP-16 VP-16 Etoposide, NSC-141540 Single-Agent
Cytoreduction followed by 3-Drug Combination Chemotherapy/Stem Cell Mobilization. HU;
followed by MCE; G-CSF.
PROJECTED ACCRUAL: 30 patients will be entered over 3 years.
DISEASE CHARACTERISTICS: Philadelphia chromosome-positive chronic myeloid leukemia (CML)
in chronic or accelerated phase Ineligible for allograft protocols or no available
HLA-matched sibling marrow donor No patients under age 55 who have consented to unrelated
donor search unless: Search unsuccessful for 6 months and unlikely a donor will be found
Transplant from an unrelated donor declined No history of CML blast crisis No grade III/IV
PATIENT CHARACTERISTICS: Age: Over 17 to under 66 Performance status: Not specified Life
expectancy: No limitations from disease other than leukemia Other: No hepatic, renal,
pulmonary, or cardiac dysfunction that would preclude transplant preparative regimen No
HIV antibody No active infection
PRIOR CONCURRENT THERAPY: At least 1 month since interferon