Selinexor in Treating Patients With Intermediate- and High-Risk Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome After Transplant

Inclusion Criteria:

* Signed, written informed consent in accordance with federal, local, and institutional guidelines
* Patients underwent allo-SCT with intermediate risk and high risk AML and high risk MDS (defined by American Society for Blood and Marrow Transplantation \[ASBMT\] criteria), who are within 60 to 100 days after allo-SCT
* There is no evidence of disease relapse at the time of screening, and minimal residual disease (MRD) is acceptable
* Eastern Cooperative Oncology Group (ECOG) performance status of =\< 2
* Absolute neutrophil count (ANC) \> 1000 uL
* Platelets \>= 20,000 without platelet transfusion
* Creatinine clearance \> 30 cc/min calculated using the Cockcroft and Gault (1976) formula or measured
* Total bilirubin =\< 2 mg/dl unless high indirect bilirubin is due to a congenital disorder
* Transaminases (aspartate aminotransferase \[AST\] or alanine aminotransferase \[ALT\]) =\< 2.0 x upper limit of normal (ULN)
* Prothrombin time (PT) and partial thromboplastin time (PTT) =\< 2 x ULN
* Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures
* It is important patients understand the need to use birth control while on this study; female patients of child-bearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening (\< 3 days prior to first dose), male patients with partners of childbearing potential must agree to use effective contraception during the study period and a period of 3 months after the last dose of study drug; for both male and female patients, effective methods of contraception must be used throughout the study and for three months following the last dose

Exclusion Criteria:

* Patients with acute GVHD grade II-IV
* Treatment with any investigational agent within three weeks prior to first dose in this study
* Major surgery within 2 weeks of first dose of study drug; patients must have recovered from the effects of any surgery performed greater than 2 weeks previously
* Patient has a concurrent active malignancy under treatment
* Unstable cardiovascular function:

  * Symptomatic ischemia, or
  * Uncontrolled clinically significant conduction abnormalities (i.e., ventricular tachycardia on antiarrhythmic agents are excluded; 1st degree atrioventricular (AV) block or asymptomatic left anterior fascicular block/right bundle branch block (LAFB/RBBB) will not be excluded), or
  * Congestive heart failure (CHF) NYHA class \>= 3, or
  * Myocardial infarction (MI) within 3 months
* Uncontrolled infection requiring parenteral antibiotics, antivirals, or antifungals within one week prior to first dose; infections controlled on concurrent anti-microbial agents are acceptable, and anti-microbial prophylaxis per institutional guidelines are acceptable
* Known active hepatitis B virus (HBV) or C virus (HCV) infection; or known to be positive for HCV ribonucleic acid (RNA) or HBsAg (HBV surface antigen)
* Known human immunodeficiency virus (HIV) infection
* Any medical condition which, in the investigator's opinion, could compromise the patient's safety
* Patients unable to swallow tablets or patients with malabsorption syndrome, or any other disease significantly affecting gastrointestinal function