VNP40101M Followed by Cytarabine in Treating Older Patients With Acute Myeloid Leukemia

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed de novo acute myeloid leukemia (AML) * No acute promyelocytic leukemia \[t(15;17)\] * No favorable cytogenetics, including t(15;17), t(8;21), or inv 16 * No secondary AML, defined as having a history of an antecedent hematologic disorder (myelodysplastic syndromes \[MDS\] or myeloproliferative disease), or history of prior chemotherapy or radiation for a disease other than AML * Must have ≥ 1 of the following poor-risk features: * Any of the following unfavorable cytogenetics: * Del (5q)/-5q * -7/del(7q) * Abnormal 3q, 9q, 11q, 20q, 21q, or 17p * t(6;9) * t(9;22) * Trisomy 8 * Complex karyotypes (≥ 3 unrelated abnormalities) * At least 70 years of age * ECOG performance status (PS) of 2 * Cardiac dysfunction\* that would limit the use of anthracycline therapy, as defined by any of the following: * Ejection fraction ≤ 50% * History of significant coronary artery disease, defined as ≥ 1 vessel stenosis requiring medical treatment, stent placement, or surgical bypass graft * History of congestive heart failure or myocardial infarction * Significant arrhythmia, including any of the following: * Atrial flutter (excluding atrial fibrillation) * Sick sinus syndrome * Ventricular arrhythmia * Heart valve disease * Mitral valve prolapse allowed * Other heart disease, at the discretion of the principal investigator * Pulmonary dysfunction not related to AML, defined by 1 of the following: * DLCO and/or FEV\_1 \< 80% and ≥ 50% normal range * Dyspnea on slight activity or at rest * Requires oxygen * Hepatic dysfunction related to chronic hepatitis or liver cirrhosis * Other organ dysfunction or comorbidity that precludes standard cytotoxic induction treatment (e.g., 3+7), at the discretion of the principal investigator NOTE: \*Patients with a history of heart disease as defined above must be on appropriate medication and have their disease under control * No known CNS disease PATIENT CHARACTERISTICS: * ECOG PS 0-2 * AST and ALT ≤ 5 times upper limit of normal * Bilirubin ≤ 2.0 mg/dL * Creatinine ≤ 2.0 mg/dL * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for 6 months after completion of study treatment * No active, uncontrolled infection * Patients with an infection who are under active treatment with antibiotics and whose infections are controlled are eligible * Chronic hepatitis allowed * No clinical evidence of ongoing second malignancy unrelated to AML or MDS * No evidence of left bundle branch block on screening ECG * No obligate use of cardiac pacemaker or atrial fibrillation PRIOR CONCURRENT THERAPY: * See Disease Characteristics * At least 24 hours since prior metronidazole * No prior low-dose, single-agent, cytotoxic chemotherapy (e.g., cytarabine, decitabine, or azacitidine) * No concurrent disulfiram * No other concurrent standard or investigational therapy for AML except for the following: * Concurrent hydroxyurea to control rising white blood cell counts * Dosage must be 4-6 grams daily for up to 4 days * Concurrent leukapheresis to control blast cell counts * Must be completed within the first 5 days of study therapy * No more than 2 procedures per day or 4 procedures total * Investigational supportive care agents (e.g., antimicrobials or antifungal agents), at the discretion of the protocol sponsor