DISEASE CHARACTERISTICS:

• Diagnosis of myelodysplastic syndromes (MDS) by FAB or WHO criteria (FAB criteria for MDS includes ≤ 29% blasts and chronic myelomonocytic leukemia)

  • Previously untreated disease

    • Patients who have initiated azacytidine (1 course only) are eligible provided that the second course will begin on study within 5 weeks from the initiation of the first course
    • Prior cytokine therapy allowed
• Patients with therapy-related MDS are eligible
• No granulocytic sarcoma as the sole site of disease

• Patients with refractory anemia or refractory anemia with ringed sideroblasts must have significant marrow dysfunction as defined by meeting 1 of the following criteria:

  • Symptomatic anemia requiring RBC transfusions for ≥ 3 months
  • Platelet count < 50,000/mm^3 on 2 occasions or clinically significant hemorrhage requiring transfusion
  • Neutrophil count < 1,000/mm^3
  • No infection requiring IV antibiotics

• CD33 expression required on ≥ 25% of left-shifted dysplastic myeloid cells, including blasts

  • Testing will be done on bone marrow aspirate (testing on peripheral blood is allowed for patients whose CD33 expression in this cellular compartment cannot be ascertained)
• No active CNS disease

PATIENT CHARACTERISTICS:

• See Disease Characteristics
• Life expectancy attributed to a co-morbid medical illness > 6 months (if applicable)
• ECOG performance status 0-2
• Platelet count ≥ 10,000/mm^3 with transfusion
• Total bilirubin < 2.0 mg/dL
• AST/ALT < 2.5 times upper limit of normal
• Creatinine < 2.0 mg/dL
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception before and during study treatment

• No uncontrolled concurrent illness including, but not limited to, any of the following:

  • NYHA class III-IV congestive heart failure
  • Unstable angina pectoris
  • Serious cardiac or ventricular arrhythmia
  • Uncontrolled active infection
  • Myocardial infarction within the past 6 months
  • Electrocardiographic evidence of acute ischemia or active conduction system abnormalities
  • Serious medical or psychiatric illness or social situations that are likely to interfere with participation in this study
• No baseline fibrinogen < 100 mg/dL or clinically significant disseminated intravascular coagulation

• More than 3 years since prior diagnosis or treatment of another malignancy except for any of the following:

  • Basal cell carcinoma or squamous cell carcinoma of the skin
  • In situ malignancy
  • Low-risk prostate cancer
• No HIV positivity requiring combination antiretroviral therapy
• No history of allergic reactions attributed to compounds of similar chemical or biologic composition to azacitidine or lintuzumab that are not easily managed
• No hypersensitivity to mannitol

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior lenalidomide or thalidomide
• More than 6 months since prior chemotherapy or radiotherapy (for other cancers)
• More than 1 month since prior and no other concurrent investigational agents

• No concurrent ongoing therapeutic anticoagulation with warfarin, Lovenox, or similar agent

  • Low-dose prophylaxis therapy allowed

• No concurrent ongoing clopidogrel therapy

  • Patients who were using clopidogrel at screening and subsequently discontinued use due to ongoing or future risk of dug- and treatment-related cytopenias are eligible
• No other concurrent anticancer agents or therapies