Decitabine Alone or in Combination With Venetoclax, Gilteritinib, Enasidenib, or Ivosidenib as Maintenance Therapy for the Treatment of Acute Myeloid Leukemia in Remission

Inclusion Criteria:

* Patients aged \>= 18 years AML who have achieved their FIRST complete response (CR) or complete response with incomplete bone marrow recovery (CRi) and are not immediately candidates for allogeneic stem cell transplant
* Patients who have received intensive therapy (defined as receiving standard or higher dose cytarabine-based therapy) to achieve remission (CR/CRi) should have received remission induction therapy and at least 1 consolidation cycle. These patients are eligible as long as they are not greater than 2 months from their last consolidation therapy and will be designated as COHORT 1 (intensive induction cohort)
* Patients who have received lower intensity therapy (defined as receiving low-dose cytarabine \[LDAC\] or hypomethylating agent \[HMA\]-based therapy) to achieve remission should have received at least 2 cycles of lower intensity therapy between the time they have achieved CR/CRi and enrollment on this protocol. They will be designated as COHORT 2 (lower intensity induction cohort)
* For either subgroup (lower or higher intensity), patients who have measurable residual disease may be enrolled on their respective cohort at any time without maximum 'time from consolidation' requirement
* Eastern Cooperative Oncology Group (ECOG) performance status of \< or = 3
* Serum total bilirubin \< or = to 1.5 x the upper limit of normal (ULN)
* Serum creatinine \< or = to 2.5 x ULN
* Absolute neutrophil count (ANC) \> 0.5 x k/uL
* Platelet count \> or = 50 x k/uL
* For females of childbearing age, they may participate if they:

  * Have a negative serum or urine pregnancy test within 10 to 14 days of enrolling
  * Agree to either abstinence or 2 effective contraceptive methods (such as barrier methods or hormonal contraception) throughout the treatment period and up to 30 days after discontinuing treatment
* For male patients with a female partner of childbearing age, they may participate if they agree to either abstinence or 2 effective contraceptive methods throughout the treatment period and up to 30 days after discontinuing treatment
* Ability to understand and sign informed consent

Exclusion Criteria:

* Diagnosis of acute promyelocytic leukemia (APL), AML - M3 by French-American-British (FAB) classification based on morphology, immunophenotype, molecular, or cytogenetics studies
* Diagnosis of AML associated t(15;17) or APL variant. Patients with t(9;22) are also ineligible unless they are unable or unwilling to receive therapy with a tyrosine kinase inhibitor
* Uncontrolled intercurrent illness including, but not limited to active uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
* Patients with active CNS (central nervous system) disease
* Patients with documented hypersensitivity to any components of the study program
* Females who are pregnant or lactating or intending to become pregnant during the study
* Patients with history of extramedullary AML, except for CNS involvement that is currently controlled, will not be eligible for enrollment
* Patient should be removed from current trial if they wish to participate and get treatment on another trial