Imatinib Mesylate and 17-N-Allylamino-17-Demethoxygeldanamycin in Treating Patients With Chronic Myelogenous Leukemia

DISEASE CHARACTERISTICS:

• Diagnosis of chronic myelogenous leukemia, including any of the following phases:

  • Blastic phase

    • Greater than 30% blasts in the peripheral blood or bone marrow
    • Previously untreated disease OR refractory to or relapsed after most recent therapy

  • Accelerated phase, defined by 1 of the following:

    • At least 15, but less than 30%, blasts in the peripheral blood or bone marrow
    • At least 30% blasts and promyelocytes in the peripheral blood or bone marrow
    • Greater than 20% peripheral blood basophilia

  • Chronic phase

    • No major cytogenetic response (less than 65% Philadelphia chromosome negative) after 12 months of prior imatinib mesylate therapy
• Philadelphia chromosome positive by routine cytogenetics

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• ECOG 0-2

Life expectancy

• At least 3 months

Hematopoietic

• Not specified

Hepatic

• Bilirubin no greater than 1.5 mg/dL
• ALT and AST no greater than 2.5 times upper limit of normal

Renal

• Creatinine less than 1.5 mg/dL

Cardiovascular

• No symptomatic congestive heart failure
• No unstable angina pectoris
• No cardiac arrhythmia

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No known allergy to eggs
• Able to swallow pills
• No ongoing or active infection
• No psychiatric illness or social situation that would preclude study compliance
• No other concurrent uncontrolled medical illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No prior stem cell transplantation

Chemotherapy

• More than 4 weeks since prior chemotherapy (except hydroxyurea or anagrelide) (at least 6 weeks for nitrosoureas or mitomycin)

Endocrine therapy

• Not specified

Radiotherapy

• More than 4 weeks since prior radiotherapy

Surgery

• No prior liver, kidney, or lung transplantation
• More than 14 days since prior major surgery (e.g., thoracotomy or intra-abdominal surgery)

Other

• Prior imatinib mesylate administered within the past 4 weeks is allowed
• No concurrent tacrolimus or cyclosporine as immunosuppressive agents
• No other concurrent investigational agents
• No concurrent combination antiretroviral therapy for HIV-positive patients

• No concurrent agents that alter CYP3A4 activity, including any of the following:

  • Grapefruit juice
  • Ketoconazole
  • Fluconazole
  • Itraconazole
  • Erythromycin
  • Clarithromycin
  • Cimetidine
  • Terfenadine
  • Astemizole
  • HIV protease inhibitors (e.g., indinavir and nelfinavir)