|Inclusion Criteria:||1) Able to understand and willing to sign an informed consent form (ICF) prior to initiation of any study-specific procedure and treatment|
2) Must be 18 years of age or older.
3) A pathologically confirmed diagnosis of AML or CMML-2 by World Health Organization (WHO) classification that is relapsed or refractory or for which no current therapies are anticipated to result in a durable remission, or MDS by WHO classification that are RAEB-1 or RAEB-2 and that have failed at least three cycles of hypomethylating therapy, or primary (PMF), post-polycythemia vera (PPMF) or post-essential thrombocythemia (PTMF) MF by WHO classification are high-risk category by the Dynamic International Prognostic Scoring System (DIPSS Plus), have >/=1% circulating blasts, and have failed treatment with ruxolitinib.
4) Eastern Cooperative Oncology Group (ECOG) performance score 0-2.
5) In the absence of rapidly progressing disease, the interval from prior treatment to time of study drug administration should be at least 2 weeks for cytotoxic agents or at least 5 half-lives for noncytotoxic agents.If a patient is on hydroxyurea to control peripheral blood leukemic cell counts, the patients must have discontinued hydroxyurea for at least 24 hours before initiation of treatment with study drug. Persistent clinically significant toxicities from prior chemotherapy must not be greater than grade 1.
6) Adequate renal function: Serum creatinine </= 2.0 mg/dL
7) Adequate hepatic function: Total bilirubin <1.5 x upper limit of normal (ULN), unless considered due to Gilbert's syndrome. Alkaline phosphatase (AP) </=2.5 x ULN, unless considered due to organ involvement of target disease. Aspartate transaminase (AST) or alanine transaminase (ALT) </=3 x ULN, unless considered due to organ involvement of target disease.
8) Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must use acceptable contraceptive methods (abstinence, intrauterine device [IUD], oral contraceptive, or double barrier device), and must have a negative serum or urine pregnancy test within 2 weeks prior to beginning treatment on this trial. Sexually active men must also use acceptable contraceptive methods for the duration of time on study.
9) Able to adhere to the study visit schedule and other protocol requirements.