Azacitidine and Chimerism in MDS or AML Patients After Allogeneic Stem Cell Transplant

Eligibility Criteria

• 1. Patients with AML/MDS/MPN, CMML post Allogeneic SCT who experience any drop in total or myeloid chimerism any time after day 30, or their day 30 or day100 myeloid donor chimerism is below 98% without concurrent hematologic relapse (that is, patients with \<5% bone marrow blasts as obtained at that time point) will be offered treatment with azacitidine
• 2. \>=30 -180 days post SCT and patients must have ANC\> 1000, PLT \> 50,000
• 3. Age 18-75 years old
• 4. Performance score of at least 70% by Karnofsky
• 5. Adequate kidney and liver function as demonstrated by:
• 1. Creatinine clearance should be \>60 ml/min
• 2. Total Bilirubin \<1.5, ALT/AST/Alk Phos \< 2.5 x normal. No evidence of chronic active hepatitis or cirrhosis.
• 6. Negative Beta HCG test in a woman with child bearing potential, defined as not post-menopausal for 12 months or no previous surgical sterilization. Women of child bearing potential must be willing to use an effective contraceptive measure while on study.
• 7. Patient or patient's legal representative, parent(s) or guardian able to sign informed consent.
• 8. Patients must be off any prior chemotherapy, radiotherapy, or other investigational therapy within 2 weeks prior to start treatment
• 1. Positive for HIV, HBsAg, HCV or other viral hepatitis or cirrhosis from any cause
• 2. Active or prior CNS leukemia, unless in complete remission for at least 2 months.
• 3. History of serious chronic mental disorder or drug-abuse accompanied by documented problems of compliance with therapeutic programs.
• 4. Uncontrolled infection
• 5. Grade III, IV graft versus host disease (GVHD