Treatment of Elderly Patients With Acute Myeloid Leukemia (AML) and High Risk Myelodysplastic (MD) Syndrome With Laromustine and Infusional Cytarabine

Inclusion Criteria:

* Diagnosis of AML based on WHO criteria (greater than 20% blasts in the bone marrow or blood) excluding AML M3, acute promyelocytic leukemia OR diagnosis of high-risk MDS defined as International Prognostic Scoring System INT-2.
* ECOG performance status equal to 0, 1, 2.
* No prior treatment for AML with myeloablative treatment. Patients may have prior treatment with a biologic therapy. Patients with MDS or AML that has evolved from MDS could have received prior low-dose cytotoxic therapy with agents such as azacytidine or low-dose Ara C.
* Ability to sign an Informed Consent according to institutional guidelines.
* Patients must have the following clinical laboratory values within 24 hours prior to beginning protocol treatment: a) serum creatinine less than or equal to 2.0mg/dl. b) total bilirubin less than or equal to 2.0 mg/dl c) ALT or AST less than or equal to 5 times the upper limit of normal.

Exclusion Criteria:

* Uncontrolled active infection. Patients with infections who are under active treatment with antibiotics and whose infections are controlled may be entered into the study. Patients with chronic hepatitis are eligible.
* Active heart disease including myocardial infarction, symptomatic coronary artery disease, arrhythmias not controlled by medication or uncontrolled congestive heart failure.
* Severe pulmonary disease not controlled with medication.
* Patients with serum creatinine \> 2.0, serum bilirubin \> 2.0. ALT or AST greater that 5 times the upper limit of normal. Patients with bilirubin or creatinine outside the acceptable levels will be considered eligible if this abnormality is clearly leukemia related and discussed with the principal's investigator prior to enrollment.
* Patients concurrently receiving any other standard or investigational treatment for leukemia with the exception of hydroxyurea.
* Since the formulation contains 30% ethanol, patients being treated with Antabuse (disulfiram) are excluded from the study.
* Patients with APL t(15;17)
* Patients with ECOG performance status of 3 or 4.
* Patients should be off metronidazole (Flagyl) at least 24 hours before starting laromustine.