Leukemia

Inclusion

• Diagnosis of acute myeloid leukemia by WHO criteria (except acute promyelocytic leukemia), or myelodysplastic syndrome with >= 10% blasts, RAEB-2 by WHO classification
• ECOG Performance Status 0 - 2
• Adequate renal and hepatic function as indicated by the following laboratory values:
• Serum creatinine =< 1.0 mg/dL; if serum creatinine > 1.0 mg/dL, then the estimated glomerular filtration rate (GFR) must be > 60 mL/min/1.73 m^2 as calculated by the Modification of Diet in Renal Disease equation
• Serum bilirubin =< 1.5 x upper limit of normal (ULN)
• Aspartate transaminase (AST) =< 2.5 x ULN
• Alanine transaminase (ALT) =< 2.5 x ULN
• Alkaline phosphatase =< 2.5 x ULN
• Capable of understanding the investigational nature, potential risks and benefits of the study, and able to provide valid informed consent
• Female patients of childbearing potential must have a negative serum pregnancy test within 2 weeks prior to enrollment
• Male and female patients must use an effective contraceptive method during the study and for a minimum of 6 months after study treatment

Exclusion

• Current concomitant chemotherapy, radiation therapy, or immunotherapy other than as specified in the protocol with the exception of intrathecal chemotherapy administered on days that are not concurrent with clofarabine and cytarabine
• No prior anti-leukemia therapy other than hydroxyurea
• Have any other severe concurrent disease, or have a history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo treatment
• Patients with significant organ compromise due to systemic fungal, bacterial, viral, or other infection
• Pregnant or lactating patients
• Any significant concurrent illness, condition, or psychiatric disorder that would compromise patient safety or compliance, interfere with consent, study participation, follow up, or interpretation of study results
• Have had a diagnosis of another malignancy, unless the patient has been disease-free for at least 3 years following the completion of curative intent therapy including the following: A) Patients with treated non-melanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia, regardless of the disease-free duration, are eligible for this study if definitive treatment for the condition has been completed; B) Patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on prostate-specific antigen (PSA) values are also eligible for this study if hormonal therapy has been initiated or a radical prostatectomy has been performed
• Prior allogeneic stem cell transplant
• No concomitant cytotoxic therapy or investigational therapy is allowed during the study