Inclusion Criteria:

- In response to their first course of frontline treatment, patients who did not
achieve a response (CR, CRi, or PR) and have ≥ 15% bone marrow blasts in a BM
specimen between day 14 - 42 from the initiation of a single frontline course. If
within that timeframe the BM is hypoplastic, the BM assessment can be repeated within
a subsequent two-week period and the patient entered into the study if there is ≥ 15%
blasts in the bone marrow.

- ≥ 55 years old

- Have an understanding of the importance of not taking paracetamol (acetaminophen) or
high dose antioxidants from 1 day before through 1 day after treatment during any
given course

- Have a life expectancy of more than 4 weeks following initiation of treatment

- Secondary AML is allowed as are antecedent hematologic disorders

- Zubrod performance status ≤ 2

- Have recovered from acute toxicities of prior chemotherapy (≤ Grade 2)

- Have signed an informed consent

- Total bilirubin ≤ 1.5 x upper normal limit (UNL) and Alanine Amino Transferase [ALT
(Serum Glutamic-pyruvic Transaminase (SGPT))] ≤ 2.5 x UNL

- Creatinine ≤ 1.5 x UNL

- Serum magnesium should be within the normal range (Mg replacement being acceptable)

- Left Ventricular Ejection Fraction (LVEF) of >50% as determined by multiple-gated
acquisition scan (MUGA) or Echocardiogram (ECHO)

- Ability to receive all courses of therapy, as outlined in the treatment schedules at
the investigative site

- Willingness to comply with scheduled follow-up as required by the protocol

- Use of adequate contraceptive techniques if premenopausal and sexually active;
examples include implantable, injectable or oral contraceptives, intrauterine devices
(IUD), sterilization, or sexual abstinence

- If premenopausal, have negative pregnancy tests at screening

Exclusion Criteria:

- Presence of any pneumonia regardless of severity or other life-threatening illness
including, but not limited to, ongoing infection, symptomatic congestive heart
failure, unstable angina pectoris, cardiac arrhythmia, high blood pressure, history
of labile hypertension, history of poor compliance with an antihypertensive regimen,
myocardial infarction less than or equal to 6 months prior to registration, diabetes,
or extensive and symptomatic interstitial fibrosis of lung, chronic liver disease or
psychiatric illness/social situations that limits compliance with study requirements

- Acute promyelocytic leukemia (APL [FAB classification M3])

- Requirement for transplant before Course 2 is complete

- Concurrent use of other experimental agents (i.e., drugs not approved for clinical
indications) or having received other investigational agents within the 30 days prior
to the start of Course 1

- Pregnancy (includes a positive pregnancy test at the screening visit) or lactation

- Known HIV infection

- Active hepatitis B or C or other active liver disease

- Presence of dyspnea at rest or with minimal exertion after correction for anemia

- Known or suspected hypersensitivity or allergy to idarubicin or ara-C

- Occurrence of major surgery within two weeks of the start of Course 1

- Chemotherapy within two weeks prior to initiation of therapy under this protocol, or
hydroxyurea within 7 days

- Patients who, with appropriate explanation, are not prepared to exclude the use of
paracetamol (acetaminophen) or paracetamol-containing medications from 1 day before
through 1 day after treatment during any course

- Patients who are not prepared to commit to the exclusion of high dose antioxidants
from 1 day before through 1 day after treatment during any given course

- Medical or psychiatric conditions that compromise the ability to give informed
consent, to comply with the protocol or to complete the study

- Inability, in the opinion of the principal investigator or clinical staff, to comply
with protocol requirements for the duration of the study