Arsenic Trioxide in Treating Patients With Chronic Phase Chronic Myelogenous Leukemia That Has Not Responded to Previous Treatment

DISEASE CHARACTERISTICS:

• Diagnosis of Philadelphia (Ph) chromosome positive (or breakpoint cluster region bcr positive) chronic myelogenous leukemia in chronic phase
• Ineligible for or refused allogeneic bone marrow transplantation
• Interferon alfa refractory or intolerant as defined by the following:
• Refractory: Failure to achieve a complete hematologic response lasting for at least 1 month after prior therapy with interferon alfa based regimen for at least 3 months 65% or more Ph positive chromosomes in bone marrow after one year of interferon alfa based therapy
• At least a 30% increase in Ph positive chromosomes in bone marrow in samples taken at least one month apart OR
• An increase of at least 65% in Ph positive chromosomes in bone marrow
• Intolerant: Grade 3 or greater nonhematologic toxicity Autoimmune phenomenon at any grade
• No accelerated phase or blastic phase disease as defined by the following:
• Greater than 15% blasts or basophils in the peripheral blood or bone marrow
• Greater than 30% blasts plus promyelocytes in the peripheral blood or bone marrow
• Documented extramedullary blastic disease outside liver or spleen
• Platelet count less than 100,000/mm3 unrelated to therapy
• Clonal evolution (additional chromosomal abnormalities other than Ph chromosome) as solitary feature is not considered accelerated disease
• No known brain metastases or central nervous system (CNS) disease

PATIENT CHARACTERISTICS:

• Age: 12 and over
• Performance status: Zubrod 0-2
• Life expectancy: At least 2 years
• Hematopoietic: See Disease Characteristics
• Hepatic: Unless due to direct disease infiltration of the liver:
• ALT and AST no greater than 2.5 times upper limit of normal (ULN)
• Bilirubin no greater than 1.5 times ULN (unless due to Gilbert's disease)
• No hepatic disease that would preclude study
• Renal: Creatinine no greater than 1.5 times ULN Creatinine clearance at least 60 mL/min
• Cardiovascular: No history of New York Heart Association grade III or IV cardiac disease
• No cardiovascular disease that would preclude study
• No unstable angina pectoris or cardiac arrhythmia that would shorten life expectancy
• Other: No history of grand mal seizures other than infantile febrile seizures
• No active secondary malignancy or other uncontrolled concurrent medical problem that would shorten life expectancy
• No neurologic, endocrine, or other major systemic disease that would preclude study
• No active infection uncontrolled by oral or IV antibiotics
• No history of hypersensitivity to the study drug or drugs with similar chemical structure
• No mental condition that would preclude study Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

• Biologic therapy: See Disease Characteristics
• No concurrent bone marrow or peripheral blood stem cell transplantation
• Chemotherapy: At least 14 days since prior chemotherapy (48 hours for hydroxyurea and 6 weeks for busulfan) and recovered (unless evidence of rapidly progressive disease)
• No other concurrent cytotoxic chemotherapy
• No prior arsenic trioxide
• Endocrine therapy: No concurrent steroids for the treatment of neoplasms (except for new adrenal failures)
• No concurrent hormones for the treatment of neoplasms (except for nondisease related conditions)
• Radiotherapy: At least 14 days since prior radiotherapy
• No concurrent radiotherapy
• Surgery: Not specified
• Other: At least 14 days since other prior investigational agent
• No other concurrent investigational or antileukemic agents