MS-275 and Azacitidine in Treating Patients With Myelodysplastic Syndromes, Chronic Myelomonocytic Leukemia, or Acute Myeloid Leukemia

Inclusion Criteria

• •Diagnosis of 1 of the following:
• •* Histologically confirmed myelodysplastic syndromes (MDS) by bone marrow aspiration and/or biopsy
• •* International Prognostic Scoring System (IPSS) score of intermediate-1, intermediate-2, or high
• •* International Prognostic Scoring System (IPSS) score of intermediate-1, intermediate-2, or high
• •* Low IPSS score allowed provided patient has a clinically significant cytopenia (i.e., absolute neutrophil count \< 1,000/mm\^3, untransfused hemoglobin \< 8 g/dL, platelet count \< 20,000/mm\^3, or anemia requiring transfusion)
• •* Chronic myelomonocytic leukemia
• •* Acute myeloid leukemia (AML)
• •* Relapsed or refractory disease
• •Untreated AML allowed provided patient meets \>= 1 of the following criteria:
• •* Age 60 and over
• •* AML arising in the setting of an antecedent hematologic disorder
• •* High-risk cytogenetic abnormalities
• •* Medical conditions that may compromise the ability to give cytotoxic chemotherapy as the primary modality
• •* Refused cytotoxic chemotherapy
• •WBC \< 30,000/mm3 for \>= 2 weeks before study entry
• •Acute promyelocytic leukemia allowed provided patient is in at least second relapse and has already received treatment regimens containing arsenic trioxide and isotretinoin
• •No clinical evidence of CNS or pulmonary leukostasis or CNS leukemia
• •Peformance status:
• •* Zubrod 0-2
• •Life expectancy:
• •* At least 6 months
• •Hematopoietic:
• •* See Disease Characteristics
• •* Hemoglobin ≥ 8 g/dL (transfusion allowed)
• •* No disseminated intravascular coagulation
• •Renal:
• •* Creatinine normal OR
• •* Creatinine clearance \>= 60 mL/min
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception during and for 3 months after study treatment
• •No untreated, active infection
• •No other serious or uncontrolled medical condition
• •More than 3 weeks since prior hematopoietic growth factors for this malignancy
• •At least 3 weeks since prior hydroxyurea (2 weeks for AML patients)
• •No concurrent hydroxyurea
• •Recovered from all prior therapy
• •At least 2 weeks since prior cytotoxic therapy (AML patients)
• •More than 3 weeks since other prior therapy for this malignancy
• •No other concurrent investigational or commercial agents or therapies for this malignancy
• •No concurrent valproic acid
• •Hepatic:
• •* Bilirubin normal unless due to hemolysis or Gilbert's syndrome
• •* AST and ALT =\< 2.5 times upper limit of normal