Combination Chemotherapy With or Without Gemtuzumab Ozogamicin or Tipifarnib in Treating Patients With Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndromes

DISEASE CHARACTERISTICS:

• Diagnosis of 1 of the following:

  • Acute myeloid leukemia (AML) meeting the following criteria:

    • De novo or secondary AML
    • No acute promyelocytic leukemia
  • High-risk myelodysplastic syndromes (> 10% marrow blasts; refractory anemia with excess blasts-2)
  • No blast transformation of chronic myeloid leukemia
• Patients ≤ 60 years of age may be eligible provided they are considered unfit for clinical trial MRC-AMLI5

PATIENT CHARACTERISTICS:

• Not pregnant or nursing
• AST and ALT ≤ 2 times upper limit of normal (ULN) (for patients receiving gemtuzumab ozogamicin)
• Bilirubin ≤ 2 times ULN (for patients receiving gemtuzumab ozogamicin)
• Creatinine normal (for patients receiving clofarabine)
• No other concurrent active malignancy except basal cell carcinoma

PRIOR CONCURRENT THERAPY:

• No prior cytotoxic chemotherapy for AML

  • Hydroxyurea or similar low-dose therapy to control WBC count prior to initiation of intensive therapy allowed
• No concurrent enzyme anticonvulsants, including phenytoin, phenobarbital, primidone, carbamazepine, or oxcarbazepine (for patients receiving tipifarnib)