Amifostine, Idarubicine et Cytarabine pour le traitement de la Leucémie Myéloïde Aiguë

OBJECTIVES: Determine whether amifostine provides systemic protection against the nonhematologic side effects of idarubicin (IDR) during induction therapy of acute myeloid leukemia (AML), allowing the dose of idarubicin to be escalated. Determine the maximum tolerated dose of idarubicin when amifostine is used as a chemotherapy protectant. Determine the incidence and severity of dose limiting hypotension in patients receiving amifostine and the ability to offset this side effect with vasoconstrictive agents. Determine whether any additional side effects of amifostine are dose limiting in patients with AML treated with IDR and cytarabine (ARA-C). Monitor the frequency of alopecia, mucositis, diarrhea, and septicemia involving enteric pathogens in these patients. Determine the requirement for intravenous hyperalimentation in patients receiving amifostine, IDR, and ARA-C. OUTLINE: This is a dose escalation study of idarubicin (IDR). Patients receive amifostine IV over 15 minutes, followed 15-30 minutes later by chemotherapy. Idarubicin IV is administered over 15 minutes on days 1-3. Cytarabine is administered by continuous infusion on days 1-7. Patients may receive 1 additional course of treatment, if necessary. Cohorts of 3-6 patients each are treated at each dose level of idarubicin. Dose escalation is discontinued when 2 or more patients experience dose limiting toxicity. Patients are followed at 3 months. PROJECTED ACCRUAL: A maximum of 36 patients will be accrued for this study.