Arsenic Trioxide in Treating Young Patients With Refractory Leukemia or Lymphoma

DISEASE CHARACTERISTICS:

• Histologically confirmed leukemia or lymphoma refractory to standard curative treatment regimens
• Measurable or evaluable disease
• No meningeal leukemia or lymphoma
• No HIV-related lymphoma
• No lymphoproliferative diseases

PATIENT CHARACTERISTICS:

Age:

• 2 to 21

  • Acute promyelocytic leukemia (APL) patients (stratum I) must be age 2 to 12

Performance status:

• ECOG 0-2

Life expectancy:

• Not specified

Hematopoietic:

• Not specified

Hepatic:

• Bilirubin normal
• SGPT less than 2 times upper limit of normal
• No significant hepatic dysfunction that would preclude study therapy

Renal:

• Creatinine normal (age adjusted) OR
• Creatinine clearance at least 60 mL/min
• Potassium, magnesium, and calcium at least lower limit of normal (oral or IV supplementation allowed)
• No significant renal dysfunction that would preclude study therapy

Cardiovascular:

• Rate corrected QTc interval no greater than 0.48 on EKG
• No significant cardiac dysfunction that would preclude study therapy
• No cardiac disease, including dysrhythmias

Pulmonary:

• No significant pulmonary dysfunction that would preclude study therapy

Other:

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No persistent grade 3 or greater sensory or motor neuropathy
• No prior grand mal seizures (grade 3 or greater) within the past 2 years other than febrile seizures (except for patients with APL at discretion of investigator)
• No clinically significant unrelated systemic illness that would preclude study therapy (e.g., serious infection)
• HIV negative

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• At least 1 week since prior colony-stimulating factors (e.g., filgrastim [G-CSF], sargramostim [GM-CSF], and epoetin alfa)
• No concurrent immunotherapy

Chemotherapy:

• No prior arsenic trioxide
• At least 2 weeks since prior chemotherapy (4 weeks for nitrosoureas) and recovered
• No concurrent intrathecal chemotherapy except for acute promyelocytic leukemia (APL) patients experiencing progressive meningeal leukemia and demonstrating benefit from arsenic trioxide for systemic disease
• No other concurrent anticancer chemotherapy

Endocrine therapy:

• No concurrent steroids (except corticosteroids for retinoic acid syndrome)

Radiotherapy:

• At least 4 weeks since prior radiotherapy and recovered
• No concurrent radiotherapy

Surgery:

• Not specified

Other:

• At least 6 months since prior anticonvulsants
• At least 1 week since prior retinoid therapy
• No concurrent retinoids
• No other concurrent investigational agents