Sorafenib in Treating Patients With Refractory or Relapsed Acute Leukemia, Myelodysplastic Syndromes, or Blastic Phase Chronic Myelogenous Leukemia

Inclusion Criteria:

• Diagnosis of 1 of the following: Acute myeloid leukemia (Acute promyelocytic leukemia (M3) allowed provided patient has failed prior therapy with both tretinoin and arsenic alone or in combination); Acute lymphoblastic leukemia; Myelodysplastic syndromes; Blastic phase chronic myelogenous leukemia (Failed OR intolerant to imatinib mesylate)
• Must have failed prior therapy with >= 1 cytotoxic- or biologic-targeted agent (e.g., hypomethylating agents, farnesyl transferase inhibitors, thalidomide, or tyrosine kinase inhibitors); Any number of prior regimens allowed
• Performance status: ECOG 0-1
• ALT =< 2.5 times upper limit of normal
• Bilirubin =< 1.5 mg/dL
• Creatinine =< 2.0 mg/dL OR Creatinine clearance >= 60 mL/min
• Fertile patients must use effective contraception
• No psychiatric illness or social situation that would preclude study compliance
• Prior bone marrow transplantation allowed
• At least 2 weeks since prior cytotoxic agents OR at least 5 half-lives for non-cytotoxic agents in the absence of rapidly progressing disease
• At least 24 hours since prior hydrea for control of peripheral blood leukemia cell counts
• Hydroxyurea allowed up to 72 hours after start of therapy with sorafenib
• No persistent, chronic, clinically significant toxicities > grade 1 from prior chemotherapy

Exclusion Criteria:

• Cytopenias secondary to multilineage bone marrow failure allowed
• Ineligible for or not willing to undergo allogeneic stem cell transplantation OR no donor available
• Absolute blast count=< 20,000/mm^3 unless patient has documented fms-like tyrosine kinase 3 internal tandem duplication
• No evidence of bleeding diathesis (except due to low platelets associated with the primary disease)
• No New York Heart Association class III or IV congestive heart failure
• No uncontrolled hypertension (i.e., sustained systolic blood pressure [BP] >= 150 mm Hg or diastolic BP >= 90 mm Hg)
• No unstable angina pectoris
• No symptomatic cardiac arrhythmia requiring and not responding to medical intervention
• Not pregnant or nursing
• No history of allergic reaction attributed to compounds of similar chemical or biological composition to the study drug
• No swallowing dysfunction that would impede oral ingestion of tablets
• No active uncontrolled infection
• No other uncontrolled illness
• No prior sorafenib
• No other concurrent investigational or commercial agents, except for standard intrathecal chemotherapy for the treatment of isolated CNS leukemic involvement
• No other concurrent anticancer agents
• No concurrent combination antiretroviral therapy for HIV-positive patients
• No concurrent therapeutic anticoagulation (Concurrent prophylactic anticoagulation [i.e., low-dose warfarin, catheter flushing with heparin] of venous or arterial access devices allowed)
• No concurrent cytochrome P450 enzyme-inducing antiepileptic agents, including, but not limited to, any of the following: Phenytoin; Carbamazepine; Phenobarbital; Rifampin
• No concurrent Hypericum perforatum (St. John's wort)