A Phase II Study of Anti-Thymocyte Globulin and Cyclosporine for Patients With Myelodysplastic Syndrome (MDS)

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Morphologically confirmed myelodysplastic syndromes (MDS)

- Refractory anemia (RA)

- RA with ringed sideroblasts

- RA with excess blasts

- Low, intermediate-1, or intermediate-2 risk by International Prognostic Scoring
System criteria

- MDS secondary to prior chemotherapy and/or radiotherapy for other malignant disorders
allowed

- Must have received prior transfusions of at least 4 units of red blood cells for
anemia within the past 60 days

- Must be concurrently registered on SWOG-S9910 and SWOG-9007

- Ineligible for or refused participation in SWOG-S9920 (HLA-identical sibling
peripheral blood stem cell transplantation)

PATIENT CHARACTERISTICS:

Age:

- 15 and over

Performance status:

- Zubrod 0-2

Life expectancy:

- Not specified

Hematopoietic:

- Not specified

Hepatic:

- Not specified

Renal:

- Not specified

Other:

- No other malignancy within the past 2 years except adequately treated basal cell or
squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated
stage I or II cancer in complete remission

- HIV negative

- Not pregnant or nursing

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- See Disease Characteristics

- Prior cytokines (e.g., interferon or interleukin), colony-stimulating factors, or
epoetin alfa allowed

- No prior bone marrow or stem cell transplantation

- No concurrent growth factors (including epoetin alfa) except filgrastim (G-CSF) or
sargramostim (GM-CSF) for neutropenia

Chemotherapy:

- See Disease Characteristics

- No prior remission induction chemotherapy for MDS

- Prior hydroxyurea allowed

Endocrine therapy:

- Not specified

Radiotherapy:

- See Disease Characteristics

Surgery:

- Not specified

Other:

- Prior amifostine allowed

- No calcium-channel blockers (diltiazem, nicardipine, or verapamil), antifungals
(fluconazole, itraconazole, or ketoconazole), antibiotics (clarithromycin or
erythromycin), or other drugs (bromocriptine or danazol) that would increase
cyclosporine concentrations for 48 hours before, during, and for 48 hours after
cyclosporine

- No antibiotics (nafcillin or rifampin) or anticonvulsants (carbamazepine,
phenobarbital, or phenytoin) that would decrease cyclosporine concentrations for 14
days before and during cyclosporine