The purpose of this study is to determine the safety and feasibility of the combination of decitabine given at a fixed dose with escalating doses of rapamycin in patients with relapsed or refractory acute myeloid leukemia.

Inclusion Criteria:

• Age greater than or equal to 18 years
• Diagnosis of AML according to WHO criteria except acute promyelocytic leukemia AND
• Refractory AML defined as a failure to achieve CR after 2 cycles of induction chemotherapy or persistence of > 40% bone marrow blasts after one cycle of chemotherapy induction OR
• Relapsed AML defined as any evidence of disease recurrence within 12 months of achieving first CR OR
• Relapsed AML after stem cell transplantation 100 days must have elapsed between transplant and emergence of recurrent AML
• ECOG performance status <3 (Appendix 1)

Exclusion Criteria:

• Abnormal renal function as evidenced by a calculated creatinine clearance ≤ 30ml/min (Cockcroft-Gault formula (Appendix 2)
• Abnormal liver function: Bilirubin >2.0 mg/dl, transaminase more than 2.5x the upper limits of normal
• Active systemic infection
• Known chronic liver disease
• Known diagnosis of human immunodeficiency virus infection (HIV)
• Patients who are post-allogeneic transplantation should not have active GVHD greater than grade 1 of skin
• Pregnant or breast feeding female subjects