Inclusion Criteria:

- Histologically or cytologically confirmed acute myeloid leukemia (AML) meeting 1 of
the following criteria:

- At least 60 years of age and not a candidate for or refused standard induction
treatment

- Poor risk cytogenetics

- AML following antecedent hematologic disorder

- Therapy-related AML

- Secondary AML

- No granulocytic sarcoma as sole site of disease

- No active CNS disease or CNS relapse

- ECOG performance status 0-2

- Life expectancy > 6 months

- Total bilirubin < 2.0 mg/dL

- Creatinine < 2.0 mg/dL

- AST and ALT < 2.5 times upper limit of normal

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No NYHA class III or IV congestive heart failure

- No uncontrolled infection

- No history of allergic reactions attributed to compounds of similar chemical or
biologic composition to decitabine that are not easily managed

- No other uncontrolled illness including, but not limited to, any of the following:

- Symptomatic congestive heart failure

- Unstable angina pectoris

- Serious cardiac arrhythmia

- Psychiatric illness or social situations that would preclude compliance with
study requirements

- No active second malignancy involving the blood or marrow or likely to progress and
require therapy in the next 6 months

- No prior therapy for AML except emergency leukapheresis or hydroxyurea for
leukocytosis

- No prior azacitidine or decitabine

- No prior cytarabine or other conventional chemotherapy agents for antecedent
hematologic disorders

- Prior myeloid growth factors, recombinant erythropoietin, thalidomide, or
lenalidomide allowed

- No concurrent palliative radiotherapy

- No other concurrent investigational agents

- No other concurrent direct anti-leukemia therapy

- No concurrent combination antiretroviral therapy for HIV-positive patients