Guadecitabine With or Without Idarubicin or Cladribine in Treating Older Patients With Previously Untreated Acute Myeloid Leukemia

Inclusion Criteria: * Previously untreated AML patients, except those who have received prior therapy with hydroxyurea, single agent chemotherapy (e.g. decitabine), hematopoietic growth factors, biological or targeted therapies are allowed * Eastern Cooperative Oncology Group (ECOG) performance status =\< 2 * Sign a written informed consent form * Total bilirubin =\< 2 mg/dL * Serum glutamate pyruvate transaminase (SGPT) or serum glutamic oxaloacetic transaminase (SGOT) =\< 4 x upper limit of normal (ULN) * Creatinine clearance of \>= 50 mL/min (estimated by the Cockcroft-Gault \[C-G\] formula) * Male patients must use an effective contraceptive method during the study and for a minimum of 8 weeks after study treatment * Baseline left ventricular ejection fraction (LVEF) \>= 40% Exclusion Criteria: * Patients with \>= New York Heart Association (NYHA) grade 3 heart disease as assessed by history and/or physical examination * Patients who received more than one full course of prior hypomethylating agents azacitidine or decitabine * Have any other severe concurrent disease, or have a history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo treatment * Patients with a systemic fungal, bacterial, viral, or other infection not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatm…