Sorafenib and Low Dose Cytarabine in Older Patients With Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome

DISEASE CHARACTERISTICS:

* Diagnosis of 1 of the following:

  * Acute myeloid leukemia (AML) by FAB criteria (By morphology and routine histochemistry and confirmed, when possible, by flow cytometric analysis of surface immunophenotype; co-expression of lymphoid markers permitted)
  * High-risk myelodysplastic syndromes defined as IPSS category of intermediate-2 or greater
* Must be considered unsuitable for intensive chemotherapy regimens
* No documented CNS involvement

PATIENT CHARACTERISTICS:

* ECOG performance status 0-2
* AST and ALT ≤ 2 times upper limit of normal (ULN)
* Bilirubin normal
* Creatinine ≤ 1.2 times ULN OR creatinine clearance ≥ 50 mL/min
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No history of other malignancies, except adequately treated nonmelanoma skin cancer, curatively treated in situ carcinoma of the cervix, or other solid tumors curatively treated with no evidence of disease for ≥ 5 years
* No upper gastrointestinal or other conditions that would preclude compliance with or administration of oral medication
* No serious illness or medical condition that would not permit the patient to be managed according to the protocol, including any of the following:

  * History of significant neurologic or psychiatric disorder that would impair the ability to obtain consent
  * Active, uncontrolled, serious infections
  * Active peptic ulcer disease
  * Evidence of bleeding diathesis
* No myocardial infarction within the past 6 months
* No congestive heart failure
* No unstable angina
* No active cardiomyopathy or unstable ventricular arrhythmia
* No poorly controlled hypertension (e.g., systolic BP ≥ 150 mm Hg or diastolic BP ≥ 95 mm Hg)
* No known hypersensitivity to the study drugs or their components
* No preexisting hypothyroidism prior to enrollment unless patient is euthyroid on medication
* No neuropathy ≥ grade 2

PRIOR CONCURRENT THERAPY:

* At least 2 days since prior hydroxyurea
* No other prior chemotherapy
* No concurrent therapeutic doses (≥ 2 mg/day) of anticoagulants (e.g., warfarin)

  * Doses of up to 2 mg/day given for prophylaxis of thrombosis are accepted provided INR is ≤ 1.5
* No other concurrent experimental drugs or anticancer therapy