Selinexor With Combination Chemotherapy in Treating Patients With Acute Myeloid Leukemia

Inclusion Criteria:

- Signed, written informed consent in accordance with federal, local, and institutional
guidelines

- Patients with newly diagnosed or relapsed/refractory AML, except acute promyelocytic
leukemia (APL), requiring intensive induction chemotherapy

- Eastern Cooperative Oncology Group (ECOG) performance status of =< 2

- Creatinine clearance > 30 cc/min calculated using the Cockcroft and Gault (1976)
formula or measured

- Total bilirubin =< 2 mg/dl unless high indirect bilirubin is due to a congenital
disorder

- Transaminases (aspartate aminotransferase [AST] or alanine aminotransferase [ALT]) =<
3.0 x upper limit of normal (ULN) unless due to leukemia infiltration

- Prothrombin time (PT) and partial thromboplastin time (PTT) =< 2 x ULN

- Willingness and ability to comply with scheduled visits, treatment plans, laboratory
tests and other study procedures

- It is important patients understand the need to use birth control while on this study;
female patients of child-bearing potential must agree to use dual methods of
contraception and have a negative serum pregnancy test at screening (< 3 days prior to
first dose), male patients with partners of childbearing potential must agree to use
effective contraception during the study period and a period of 3 months after the
last dose of study drug; for both male and female patients, effective methods of
contraception must be used throughout the study and for three months following the
last dose

Exclusion Criteria:

- Treatment with any investigational agent within two weeks prior to first dose in this
study; hydroxyurea is allowed to control the AML prior to treatment on the study

- AML central nervous system (CNS) involvement

- Major surgery within 2 weeks of first dose of study drug; patients must have recovered
from the effects of any surgery performed greater than 2 weeks previously

- Patient has a concurrent advantage active malignancy under treatment

- Unstable cardiovascular function:

- Symptomatic ischemia, or

- Uncontrolled clinically significant conduction abnormalities (i.e., ventricular
tachycardia on antiarrhythmic agents are excluded; 1st degree atrioventricular
[AV] block or asymptomatic left anterior fascicular block/right bundle branch
block [left anterior fascicular block (LAFB)/right bundle branch block (RBBB)]
will not be excluded), or

- Congestive heart failure (CHF) New York Heart Association (NYHA) class >= 3, or

- Myocardial infarction (MI) within 3 months

- Uncontrolled infection requiring parenteral antibiotics, antivirals, or antifungals
within one week prior to first dose; infections controlled on concurrent
anti-microbial agents are acceptable, and anti-microbial prophylaxis per institutional
guidelines is acceptable

- Known active hepatitis B virus (HBV) or C virus (HCV) infection; or known to be
positive for HCV ribonucleic acid (RNA) or HBsAg (HBV surface antigen)

- Known human immunodeficiency virus (HIV) infection

- Any medical condition which, in the investigator's opinion, could compromise the
patient's safety

- Patients unable to swallow tablets or patients with malabsorption syndrome, or any
other disease significantly affecting gastrointestinal function

- Seizure or cerebrovascular accident (CVA) in the last year