Combination Chemotherapy With or Without Peripheral Stem Cell Transplantation in Treating Patients With Myelodysplastic Syndrome or Acute Myelogenous Leukemia

DISEASE CHARACTERISTICS:

• Pathological confirmation of one of the following:

  • Untreated refractory anemia with excess blasts (RAEB) in transformation
  • RAEB with greater than 10% blasts cells in the bone marrow
  • Other myelodysplastic syndromes
  • Profound cytopenias
  • Acute myelogenous leukemia (AML) supervening after overt myelodysplastic syndromes (MDS) of more than 6 months duration
• No blast crisis of chronic myeloid leukemia
• No leukemias supervening after other myeloproliferative disease
• No leukemias supervening after overt MDS of less than 6 months duration

• The following are allowed:

  • Secondary acute leukemias following Hodgkin's disease or other malignancies
  • Secondary leukemias following exposure to alkylating agents or radiation

PATIENT CHARACTERISTICS:

Age:

• 16-60

Performance status:

• WHO 0-2

Hematopoietic:

• If RAEB, blasts cells of greater than 10% in bone marrow
• Neutrophil count less than 5,000 or Platelet count less than 200,000
• Chronic myelomonocytic leukemia (CMML) with greater than 5% blasts cells in bone marrow, or CMML with neutrophil count greater than 160,000 or monocyte count greater than 2,600

Hepatic:

• Bilirubin no greater than 1.5 times normal

Renal:

• Creatinine no greater than 1.5 times normal

Cardiovascular:

• No patients with severe heart failure requiring diuretics or an ejection fraction of less than 50%

Neurological:

• No severe concomitant neurological disease

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• No treatments within the past 4 weeks of:

  • Biological response modifiers AND/OR
  • Low dose Ara-C

Chemotherapy:

• No prior intensive treatment for MDS or AML

Endocrine therapy:

• Not specified

Radiotherapy:

• No prior treatment for MDS or AML

Surgery:

• Not specified