Inclusion Criteria:

- Bone marrow aspirate and/or biopsy-confirmed diagnosis of 1 of the following:

- Myelodysplastic syndromes (MDS)

- Any International Prognostic Score (IPSS) eligible

- Patients with low or intermediate-1 IPSS must have platelet count <
50,000/mm³ and/or absolute neutrophil count < 500/mm³

- Blast count < 20%

- Chronic myelomonocytic leukemia (dysplastic subtype)

- WBC < 12,000/mm³ (measured twice within the past 4 weeks, 2 weeks apart)

- Acute myeloid leukemia with multilineage dysplasia (AML-TLD)

- Formerly diagnosed refractory anemia with excess blasts in transformation
by FAB criteria allowed

- AML-TLD by WHO criteria allowed in patients with no history of antecedent
hematologic disorder

- WBC ≤ 30,000/mm³ (measured twice within the past 4 weeks, 2 weeks apart)

- WBC that has doubled over 4 weeks AND > 20,000/mm³ is not eligible

- Evidence of ≥ 20% blasts on review of the bone marrow aspirate and/or
biopsy

- SWOG patients must be enrolled in research study trial SWOG-9007

- Therapy-induced MDS, AML-TLD, or chronic myelomonocytic leukemia (dysplastic subtype)
allowed

- No clinical evidence of CNS or pulmonary leukostasis or disseminated intravascular
coagulation

- No clinical evidence of CNS leukemia

- No filgrastim (G-CSF) or pegfilgrastim during days 1-10 of each treatment course

- ECOG performance status 0-2

- Life expectancy ≥ 6 months

- Creatinine < 2.0 mg/dL

- Bilirubin normal (unless due to intramedullary or extramedullary hemolysis, or
Gilbert's syndrome)

- AST and ALT ≤ 2.5 times upper limit of normal

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No active infections

- No advanced malignant hepatic tumors

- No other serious or uncontrolled medical conditions

- No known hypersensitivity to azacitidine or mannitol

- Recovered from prior therapy

- No prior azacitidine, decitabine or entinostat

- No prior induction chemotherapy for AML or stem cell transplantation

- No hematopoietic growth factors within 3 weeks prior to study entry

- No other concurrent investigational or commercial agents or therapies for the
malignancy

- No concurrent valproic acid, epoetin alfa, or darbepoetin alfa