Tipifarnib and Etoposide in Treating Older Patients With Newly Diagnosed, Previously Untreated Acute Myeloid Leukemia

Criteria:

* Pathologically confirmed newly diagnosed acute myeloid leukemia (AML)
* Subtypes M0, M1, M2, M4-7 disease
* No newly diagnosed acute promyelocytic leukemia (M3)
* Any of the following diseases:
* De novo disease
* Secondary AML
* Myelodysplasia (MDS)-related AML (MDS/AML)
* Treatment-related AML
* Previously untreated disease
* Patients who have received prior hydroxyurea alone or non-cytotoxic therapies for MDS (e.g., thalidomide, interferon, cytokines, 5-azacytidine, or revlimid) will be eligible for this study
* Must be considered ineligible for traditional antileukemia chemotherapy
* No hyperleukocytosis with ≥ 30,000 blasts/uL or rapidly rising blast count with projected doubling time of =\< 2 days
* Patients may receive hydroxyurea to lower blast count to \< 30,000 blasts/uL up to 24 hours before beginning tipifarnib and etoposide
* No active CNS leukemia
* No prior tipifarnib or etoposide
* No concurrent radiotherapy, immunotherapy, or other chemotherapy
* No concurrent enzyme-inducing anticonvulsants (e.g., phenytoin, fosphenytoin, phenobarbital, primidone, carbamazepine, or oxcarbazepine)
* Patients may be changed to non-enzyme-inducing anticonvulsants and stabilized before starting study treatment

Inclusion Criteria:

* ECOG performance status 0-2
* Serum creatinine =\< 2.0 mg/dL
* SGOT and SGPT =\< 3 times upper limit of normal
* Bilirubin =\< 2 mg/dL

Exclusion Criteria:

* Active, uncontrolled infection
* Patients with infection under active treatment and controlled with antimicrobials are eligible
* Presence of other life-threatening illnesses
* Patients with mental deficits and/or psychiatric history that preclude them from giving informed consent or from following protocol
* Allergies to imidazoles (e.g., clotrimazole, ketoconazole, miconazole, or econazole)