Aflibercept in Treating Patients With Myelodysplastic Syndromes

Inclusion Criteria: * Patients must have histologically or cytologically confirmed myelodysplastic syndromes (MDS), including any of the following: * Secondary MDS * MDS/myeloproliferative disorders (MPD) (e.g., chronic myelomonocytic leukemia or atypical chronic myeloid leukemia) * IPSS scores of 0.5 or greater (≥ INT-1) OR transfusion dependent despite use of growth factors * No more than 20% blasts in the marrow * Patients who have not responded after 3 courses of hypomethylating agents (azacitidine or decitabine) OR; who are unable to tolerate hypomethylating agents OR who refused to receive hypomethylating agents are eligible for this study * ECOG performance status ≤ 2 (Karnofsky ≥ 60%) * Total bilirubin ≤ 1.5 x upper limit of normal (ULN) * AST/ALT ≤ 2.5 x ULN * Creatinine ≤ 1.5 x ULN OR creatinine clearance ≥ 60 mL/min * Urine protein:creatinine ratio \< 1 OR urine protein \< 500 mg by 24-hour urine collection * PT INR ≤ 1.5 * Patients with PT INR \> 1.5 on full-dose anticoagulants (e.g., warfarin) are eligible provided both of the following criteria are met: * Patient has an in-range INR (usually between 2 and 3) and is on a stable dose of oral anticoagulant or low molecular weight heparin * Patient has no active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices) * Not pregnant or nursing * Fertile patients must use effective contraception during and for at least 6 months after completion of study treatment * Prior DNA-demethylating agent therapy or lenalidomide therapy allowed * Prior treatment with other molecular agents, such as thalidomide, valproic acid, or imatinib mesylate allowed Exclusion Criteria: * Evidence of active malignancies other than squamous cell or basal cell carcinoma of the skin * Known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies * History of allergic reactions attributed to compounds of similar chemical or biologic composition to agents used in the study * Serious or non-healing wound, ulcer, or bone fracture * History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days * Significant traumatic injury within the past 28 days * Clinically significant cardiovascular disease, including any of the following: * History of cerebrovascular accident (CVA) within the past 6 months * Uncontrolled hypertension, defined as blood pressure \> 150/100 mm Hg or systolic BP \> 180 mm Hg if diastolic blood pressure \< 90 mm Hg (on at least 2 repeated determinations on separate days) within the past 3 months * Myocardial infarction or unstable angina within the past 6 months * New York Heart Association class III or IV congestive heart failure, serious cardiac arrhythmia requiring medication, or unstable angina pectoris within the past 6 months * Clinically significant peripheral vascular disease within the past 6 months * Pulmonary embolism, deep vein thrombosis (DVT), or other thromboembolic event within the past 6 months * Evidence of bleeding diathesis or coagulopathy * Concurrent uncontrolled illness including, but not limited to, ongoing or active infection or psychiatric illness/social situation that would limit compliance with study requirements * Prior cytotoxic chemotherapy for MDS * Molecular therapy or immunosuppressive agents (including steroids) within the past 3 weeks * Other prior antiangiogenesis agents * Coronary artery bypass graft (CABG) within the past 6 months * Valproic acid should be discontinued at least 24 hours before aflibercept administration, unless needed for seizure control * Major surgical procedure or open biopsy within the past 28 days * Core biopsy (other than bone marrow biopsy) within the past 7 days * Anticipation of need for major surgical procedures during the course of the study * Patients may not be receiving any other investigational agents