RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Combining more than one drug may kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of cyclophosphamide plus topotecan in
treating patients who have refractory or relapsed acute myelogenous leukemia.
OBJECTIVES: I. Evaluate the efficacy of cyclophosphamide followed by topotecan in patients
with relapsed or refractory acute myelogenous leukemia. II. Confirm safety and tolerability
of this combination on this schedule in these patients.
OUTLINE: Patients receive cyclophosphamide intravenously over 1 hour on day 1 followed by
topotecan as a continuous 120 hour infusion starting 12 hours after completion of
cyclophosphamide. Treatment may be repeated every 3-6 weeks for at least 2 courses.
PROJECTED ACCRUAL: A total of 26 patients will be accrued for this study.
DISEASE CHARACTERISTICS: Histologically proven acute myelogenous leukemia by bone marrow
aspirate or biopsy Clear evidence of relapse or residual disease with greater than 5%
blasts on bone marrow examination or greater than 30% peripheral blasts No active CNS
leukemia Not eligible for potentially curative allogeneic or autologous bone marrow
transplantation without further surgery Must have failed to achieve a complete remission
with conventional chemotherapy (cytarabine based) or have relapsed within 12 months after
PATIENT CHARACTERISTICS: Age: 18 and over Performance status: ECOG 0-2 Life expectancy: At
least 6 weeks Hematopoietic: See Disease Characteristics Hepatic: Bilirubin less than 1.6
mg/dL (unless due to disease) Renal: Creatinine less than 1.6 mg/dL (unless due to
disease) No prior hemorrhagic cystitis Other: Not pregnant Fertile patients must use
effective contraception No active uncontrolled infection
PRIOR CONCURRENT THERAPY: Biologic therapy: See Disease Characteristics Chemotherapy: See
Disease Characteristics Recovered from prior chemotherapy No other concurrent chemotherapy
Endocrine therapy: Not specified Radiotherapy: Must have recovered from prior radiotherapy
Surgery: Not specified