5-Fluoro-2'-Deoxycytidine and Tetrahydrouridine in Treating Patients With Acute Myeloid Leukemia or Myelodysplastic Syndromes

Inclusion Criteria

• •Patients must have the following diagnosis:
• •Acute myeloid leukemia
• •* Relapsed or refractory
• •* Newly diagnosed in patients age 60 and above or of any age unable to receive standard induction regimen
• •Patients with MDS with an International Prognostic Scoring System (IPSS) score \>= 0.5
• •* Newly diagnosed
• •* Relapsed or refractory
• •Any prior therapy must have been completed \>= 2 weeks prior to enrollment and the participant must have recovered to eligibility levels from prior toxicity
• •No limit to number of prior regimens
• •Hydroxyurea is allowed prior to enrollment to keep white blood cell count (WBC) below 20 K
• •Valproic acid not being used for seizure control should be stopped 72 hours before starting therapy
• •Prior therapy with hypomethylating agent (decitabine or azacitidine) is allowed and must be completed \>= 6 weeks prior to enrollment
• •Relapsed patients are eligible post allogeneic or matched unrelated donor (MUD) transplant after 100 days; there should be no active acute graft versus host disease of any grade and patient should not be receiving immunosuppression for acute graft versus host disease; the patient must not have Chronic Graft versus Host disease (cGvHD) other than mild skin, oral, or ocular cGvHD not requiring systemic immunosuppression
• •Relapsed patients are eligible post autologous transplant after 100 days post transplant, with recovery of their counts absolute neutrophil count (ANC) \> 1000 and platelets greater than 75K at some point post transplant
• •Karnofsky performance status \>= 60%
• •Total bilirubin \< 1.5 x institutional upper limit of normal
• •Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase \[SGPT\]) =\< 2.5 x institutional upper limit of normal
• •Creatinine \< 1.5 x institutional upper limit of normal OR creatinine clearance \>= 60 mL/min for patients with creatinine levels above 1.5 x institutional upper limit of normal
• •Pregnant women will be excluded from this trial; nursing women are also excluded; women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for the duration of study participation, and for 3 months after completion of study; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
• •Ability to understand and the willingness to sign a written informed consent document
• •Patients should not be receiving any other investigational agents