Inclusion Criteria:

- Able to understand and have the ability to provide written consent

- Between 18 and 70 years of age

- Patients with CD33 positive (determined as CD33 expression in ≥ 20% of leukemic
blasts) de novo AML that did not respond to first line induction therapy

- ECOG Performance Status of 0-2

- Patients must have the following laboratory values within 48 hours prior to beginning
protocol treatment: Serum creatinine ≤ 1.5 mg/ml and calculated creatinine clearance
≥ 50mL/min (using the Cockcroft-Gault equation); AST ≤ 59 IU/L; ALT ≤ 72 IU/L; Total
bilirubin ≤ 1.3 mg/ml; Note: Hematologic abnormalities will not be used as a criteria
for entry or exclusion.

- Patients must have left ventricular ejection fraction (LVEF) ≥50%

- Females of child-bearing potential must have a negative pregnancy test during
screening and all subjects must agree to use an effective method of contraception.

Exclusion Criteria:

- Patients with acute promyelocytic leukemia

- Prior use of mitoxantrone or etoposide or gemtuzumab ozogamicin

- Antecedent hematologic disorder preceding initial presentation of AML or therapy
related AML

- History of thromboembolic event within the past 12 months

- Hepatitis B or C or HIV positive serology

- Symptomatic central nervous system (CNS) involvement

- History of congestive heart failure

- Myocardial infarction in the past 6 months

- Uncontrolled, life-threatening infection that is not responding to antimicrobial
therapy

- History of psychiatric disorder which may compromise compliance with the protocol or
which does not allow for appropriate informed consent

- Patient may not be receiving any other anti neoplastic investigational agents

- INR> 1.5 or patient is receiving systemic anticoagulation (e.g warfarin)

- Patient undergone autologous or allogeneic stem cell transplantation

- Other active malignancies except for non-melanoma skin cancer or cervical
intraepithelial neoplasia

- Women who are pregnant or breastfeeding.