Liposomal Annamycin in Children and Young Adults With Refractory or Relapsed ALL or AML

Inclusion Criteria:

1. Diagnosis of refractory or relapsed ALL or AML.
2. 12 months to 21 years of age at the time of informed consent.
3. Weight ≥10 kg
4. No chemotherapy, radiation, or major surgery within 2 weeks prior to first dose of study drug and recovered from the toxic side effects of such therapy. In the instance of rapidly progressive disease, anti-leukemia therapy may be administered within the 2-week period as long as the subject has recovered from the toxic effects of that therapy. Also, intrathecal therapy may be administered within the 2-week period for subjects with CNS disease.
5. No stem cell transplant regimen within 3 months prior to first dose of study drug.
6. No conventional granulocyte colony stimulating factor (G-CSF) within 7 days prior to the first dose of study drug, and no long-acting G-CSF (Neulasta) within 14 days prior to the first dose of study drug.
7. No investigational therapy within 4 weeks prior to first dose of study drug.
8. Karnofsky Performance Status ≥50% for subjects ≥10 years of age and Lansky Performance Status ≥60% for subjects \<10 years of age. Subjects who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance status.
9. Adequate liver function \[bilirubin ≤2 times the upper limit of normal (ULN) and serum glutamic-pyruvic transaminase (SGPT) ≤5 times the ULN\].
10. Adequate renal function (creatinine clearance ≥60 ml/min/1.73m2).
11. Adequate cardiac function \[ejection fraction (EF) \>50% or shortening fraction (SF) \>28% by echocardiogram or MUGA\]
12. Informed consent signed by subject or legal guardian per investigational site guidelines.
13. Able to comply with the requirements of the protocol.
14. Females of childbearing potential must have a negative serum or urine pregnancy test within 72 hours prior to first dose of study drug.
15. All subjects (male and female) of childbearing potential must agree to practice effective contraception during the entire study period, unless documentation of infertility exists. Should a female become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.

Exclusion Criteria:

1. Concomitant therapy that includes other chemotherapy that is or may be active against ALL or AML, except for prophylaxis and/or treatment of opportunistic or other infection with antibiotics, antifungals and/or antiviral agents. Concurrent radiation therapy and immunosuppressive therapy are not allowed. Concurrent intrathecal therapy per standard of care is allowed for subjects with CNS disease.
2. Any condition which, in the opinion of the Investigator, places the subject at unacceptable risk if he/she were to participate in the study.
3. Clinically relevant serious co-morbid medical conditions including, but not limited to, active infection, recent (≤6 months) myocardial infarction, unstable angina, symptomatic congestive heart failure, uncontrolled hypertension, uncontrolled cardiac arrhythmias, chronic obstructive or chronic restrictive pulmonary disease, and cirrhosis, or psychiatric illness/social situations that would limit compliance with study requirements. Cardiac patients with a New York Heart Association (NYHA) classification of 3 or 4 will be excluded.
4. Active graft-versus-host disease (GVHD).
5. Pregnant, lactating, or not using adequate contraception.
6. Known allergy to doxorubicin or anthracyclines.
7. Any evidence of mucositis/stomatitis, except for Grade 1 mucositis/stomatitis due to chronic GVHD.