Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Acute Promyelocytic Leukemia

DISEASE CHARACTERISTICS:

• New clinically and morphologically confirmed diagnosis of acute promyelocytic leukemia (APL) (bone marrow or peripheral blood)

  • Bone marrow is highly preferred but in cases where marrow cannot be obtained at diagnosis, peripheral blood will be accepted
• If the real-time quantitative (RQ)-PCR results are known, the patient must demonstrate PML-RARA and/or RARA-PML transcripts by RQ-PCR
• Patients without evidence of APL by bone marrow or peripheral blood morphology but with isolated myeloid sarcoma (myeloblastoma; chloroma, including leukemia cutis) are eligible provided that the t(15;17) translocation is documented on either marrow or tumor tissue by cytogenetics, FISH, or PCR prior to study enrollment (in this situation, touch preps from the tumor site can be evaluated by FISH with PML-RARA probes)

PATIENT CHARACTERISTICS:

• No minimal performance status criteria
• Not pregnant or nursing
• Fertile patients must use effective contraception
• No pre-existing prolonged QT syndrome

PRIOR CONCURRENT THERAPY:

• Prior intrathecal cytarabine prior to the diagnosis of acute promyelocytic leukemia (APL) allowed
• Prior corticosteroids, hydroxyurea, and leukapheresis allowed
• No prior systemic definitive treatment for APL or other suspected leukemia, including cytotoxic chemotherapy, retinoids, or arsenic