Phenylbutyrate and Tretinoin in Treating Patients With Hematologic Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed myelodysplastic syndrome (MDS)

  • Refractory anemia
  • Primary refractory leukopenia or thrombocytopenia with morphologic features of MDS
  • Refractory anemia with excess blasts (RAEB)
  • Refractory anemia with ringed sideroblasts
  • RAEB in transformation

  • Must have excess blasts or be hematopoietically compromised, defined as one of the following:

    • RBC transfusion dependent
    • Granulocyte count less than 1,000/mm^3
    • Platelet count less than 50,000/mm^3 OR

• Diagnosis of chronic myelomonocytic leukemia

  • Hematopoietically compromised (as defined above) OR
  • Excess blasts OR
  • Evaluable disease related symptomatology (organomegaly or leukemia cutis) OR

• Diagnosis of acute myeloid leukemia

  • WBC less than 20,000/mm^3 and stable for at least 2 weeks
  • Unlikely to require cytotoxic therapy during study
• No CNS or pulmonary leukostasis or CNS leukemia

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• Zubrod 0-2

Life expectancy:

• Not specified

Hematopoietic:

• See Disease Characteristics
• Hemoglobin at least 8 g/dL (transfusion allowed)
• No disseminated intravascular coagulation

Hepatic:

• Bilirubin less than 2.0 mg/dL (unless due to hemolysis or Gilbert's syndrome)

Renal:

• Creatinine less than 2.0 mg/dL

Other:

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception for 2 weeks prior, during, and for 3 months after study
• No active infection

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• See Disease Characteristics
• At least 3 weeks since prior biologic therapy, including hematopoietic growth factors, and recovered

Chemotherapy:

• See Disease Characteristics
• At least 3 weeks (1 month for MDS patients) since prior chemotherapy and recovered

Endocrine therapy:

• Not specified

Radiotherapy:

• At least 3 weeks since prior radiotherapy and recovered

Surgery:

• Not specified