Vaccine Therapy and GM-CSF in Treating Patients With Acute Myeloid Leukemia in Remission

DISEASE CHARACTERISTICS:

• Diagnosis of acute myeloid leukemia (AML), defined by the presence of > 20% blasts in marrow or blood, including the following subtypes:

  • De novo AML, defined as AML with no clinical history of prior myelodysplastic syndromes (MDS) or myeloproliferative disorder (MPD) or exposure to potentially leukemogenic therapies or agents

  • Secondary AML, defined as the following:

    • AML secondary to prior existing MDS or MPD or development of AML secondary to proven leukemogenic exposure
    • History of fatigue, bleeding, or recurrent infections preceding diagnosis of AML by ≥ 1 month with confirmation of existing peripheral blood film that demonstrates morphologic dysplasia

• In first complete remission (CR) (patients ≥ 55 years of age) OR second CR (patients ≥ 18 years of age) within the past month

  • FAB stages M0-M2 and M4-M7 allowed if in first CR

    • No acute promyelocytic leukemia in first CR
  • FAB stages M0-M7 allowed if in second CR

  • Marrow blast count < 5% (≤ 200 nucleated cell count)

    • No blasts in blood
• HLA-A2 positive at 1 allele
• No extramedullary disease
• No Auer rods
• No active meningeal or CNS leukemia

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• Life expectancy must not be severely limited by other diseases
• Absolute neutrophil count > 1,000/mm^3
• Platelet count > 100,000/mm^3
• Bilirubin < 2 mg/mL
• ALT < 2 times upper limit of normal
• Creatinine ≤ 1.6 mg/mL
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Antineutrophil cytoplasmic antibody negative
• No serious medical condition, laboratory abnormality, or psychiatric illness that would preclude study compliance or increase risk to patient
• No other malignancy within the past 5 years except basal cell or squamous cell carcinoma or carcinoma in situ of the cervix or breast
• No known allergy to incomplete Freund's adjuvant
• No hypercalcemia

• No progressive viral or bacterial infection

  • Must be afebrile for 7 days without antibiotics
• No symptomatic cardiac disease
• LVEF ≥ 40%
• No symptomatic pulmonary disease
• FEV_1, FVC, and DLCO ≥ 50% of predicated (without bronchodilator)
• No history of HIV positivity or AIDS
• No known hypersensitivity to sargramostim (GM-CSF), yeast-derived products, or any component of this product
• No history of Wegener's granulomatosis or vasculitis

PRIOR CONCURRENT THERAPY:

• Recovered from prior surgery and/or radiotherapy
• No prior allogeneic or syngeneic stem cell transplantation
• No prior solid organ transplantation
• No prior vaccine therapy for AML

• More than 28 days since prior chronic use (> 2 weeks) of corticosteroids > 10 mg/day (prednisone [or equivalent])

  • Concurrent topical or inhaled corticosteroids allowed
• More than 3 months since prior experimental therapy, cyclosporine, or tacrolimus
• No concurrent radiotherapy