Ruxolitinib in Combination With Venetoclax With and Without Azacitidine in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia

Inclusion Criteria: * Ability to understand and the willingness to sign a written informed consent document * Age \>= 18 years at time of informed consent. Persons of all genders and gender identities, and members of all races and ethnic groups will be included * Morphologically documented relapsed/refractory (R/R) AML or R/R secondary AML (sAML) that has progressed after at least 1 prior therapy for AML * Prior treatment with venetoclax and azacitidine is allowed * Treatment with hydroxyurea will not be considered a line of therapy * Patients with morphologically documented myelodysplastic syndrome (MDS) that has progressed on hypomethylating agent (HMA) therapy also will be considered if the patient is ineligible for induction with intensive chemotherapy (IC), defined for this study as meeting one or more of the following criteria: * Severe cardiac disorder (e.g., congestive heart failure requiring treatment, left ventricular ejection fraction (LVEF) of ≤ 50%, or chronic stable angina) * Severe pulmonary disorder, certified by the managing physician * Creatinine clearance of \< 45 ml/min or * Hepatic disorder with total bilirubin \> 1.5 x upper limit of normal (ULN) * Eastern Cooperative Oncology Group (ECOG) equal to 2 * Other comorbidity(ies) judged to be incompatible with high dose chemotherapy by the managing physician will be considered, at the discretion of the principal investigator (PI) * ECOG performance status 0 to 2 * Persons of c…