Mitoxantrone Hydrochloride, Etoposide, and Hydroxychloroquine in Treating Patients with Relapsed Acute Myelogenous Leukemia

Inclusion Criteria

• Able to understand and have the ability to provide written consent
• Patients with AML in the first morphologic relapse as defined by >= 5% reappearance of leukemia blasts in the bone marrow not attributable to any other cause who have not yet received chemotherapy for the current relapse
• Eastern Cooperative Oncology Group performance status of 0 -2
• Serum creatinine =< 1.5 mg/dl and calculated creatinine clearance >= 50 mL/min (using the Cockcroft-Gault equation)
• Aspartate aminotransferase (AST) =< 5 x the upper limit of normal; alanine aminotransferase (ALT) =< 5 x the upper limit of normal
• Direct bilirubin =< 1.5 mg/dl; Note: as many eligible patients will be pancytopenic secondary to their disease or prior treatments, hematologic abnormalities will not be used as a criteria for entry or exclusion
• Left ventricular ejection fraction (LVEF) >= 50 %
• Females of child-bearing potential must have a negative pregnancy test during screening and all subjects must agree to use an effective method of contraception; a woman is eligible to enter and participate in the study if she is of: * Non-childbearing potential (i.e., physiologically incapable of becoming pregnant) including any female who has had a hysterectomy or has had a bilateral oophorectomy (ovariectomy) * Childbearing potential, has a negative serum pregnancy test during the screening period and agrees to avoid sexual activity or use accepted methods of contraception from screening through follow-up * Men with a female partner of childbearing potential are eligible to enroll and participate in the study if they have had either a prior vasectomy or agree to avoid sexual activity or use appropriate barrier contraception from screening through post-treatment follow-up

Exclusion Criteria

• Acute promyelocytic leukemia
• Prior chemotherapy regimen given for first (1st) relapse, not including the use of hydroxyurea or plasmapheresis that is used prior to the initiation of chemotherapy
• Previous use of mitoxantrone and etoposide combination therapy within the preceding 180 days of screening
• Symptomatic central nervous system (CNS) involvement
• Uncontrolled, life-threatening infection that is not responding to antimicrobial therapy
• History of psychiatric disorder which may compromise compliance with the protocol or which does not allow for appropriate informed consent
• Current receiving any other anti-neoplastic investigational agents
• Prior autologous or allogeneic stem cell transplantation
• Concurrent malignancy; exceptions: patients who have been disease-free for 5 years, or subjects with a history of completely resected non-melanoma skin cancer or successfully treated in situ carcinoma are eligible; subjects with concurrent malignancies that are indolent or definitely treated may be enrolled
• Women who are pregnant or breastfeeding
• Evidence of severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory or cardiac disease)
• Inability to take oral medications, due to impaired swallowing ability or poor absorption capacity
• Known glucose-6-phosphate dehydrogenase (G-6PD) deficiency