Inclusion Criteria:

- Cytologically or histologically confirmed acute myeloid leukemia (AML) with :

- At least 60 years of age and fit for intensive chemotherapy: PS <2 (ECOG)

- Absence of significant co-morbidities

- Less than 75 years* of age

- LAM with high risk features (blasts > 20% in bone marrow)

- Poor risk cytogenetics

- Life expectancy > 1 month

- Affiliated to social security regimen

- No granulocytic sarcoma as sole site of disease

- Able and willing to provide written and signed informed consent

Exclusion Criteria:

- Total bilirubin > 2 times upper limit of normal

- AST and ALT and/or alkaline phosphatase > 4 times upper limit of normal if not in
relation with AML.

- Factor V < 50% without DIC (Disseminated Intravascular Coagulation)

- NYHA class III or IV congestive heart failure (Echo < 40%, LVEF < 50%),Unstable
angina pectoris, Serious cardiac arrhythmia

- Renal failure not related to AML: serum creatinin > 170 μmol/L or clearance of
creatinin ≤ 50 mL/mn

- Known HIV 1- HIV 2 positivity

- Prior therapy with azacitidine or lenalidomide

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

- Uncontrolled infection

- Urgent chemotherapy for DIC, spontaneous tumoral lyse syndrome, leucostase without
cytogentic results

- Women who are pregnant or breastfeeding

- Women who are unwilling or unable to use an acceptable contraceptive method to avoid
pregnancy

- Men who are unwilling or unable to use an acceptable method of birth control