Azacytidine and Bortezomib in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia or Myelodysplastic Syndromes

Inclusion criteria: * Patients must be \>18 with relapsed or refractory acute myeloid leukemia (AML) and high risk (by IPSS scoring) Myelodysplastic Syndromes (MDS) * Patients with secondary AML or therapy related disease (t-AML) are eligible If decitabine or Vidaza was a prior treatment for MDS or AML patient is eligible.Prior Velcade is also permitted. * ECOG performance status 0-2 * Life expectancy \> 6 months for patients with a co-morbid medical illness * Total bilirubin \< 2.0mg/dL * AST/ALT \< 2.5 times upper limit of normal (ULN) * Creatinine \< 2.0 mg/dL * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception prior to and during study treatment * Ability to understand and willingness to sign the written informed consent document * Active infection is allowed provided it is under control Exclusion criteria: * History of allergic reactions attributed to compounds of similar chemical or biologic composition to azacytidine or bortezomib that are not easily managed * Hypersensitivity to bortezomib, boron, or mannitol * Uncontrolled intercurrent illness including, but not limited to: * Symptomatic congestive heart failure * Unstable angina pectoris * Serious cardiac arrhythmia * Psychiatric illness/social situations that would limit compliance with study * Myocardial infarction within 6 months prior to enrollment * New York Heart Association (NYHA) Class III or IV congestive heart failure * Uncontrolled angina * Severe uncontrolled ventricular arrhythmia * Electrocardiographic evidence of acute ischemia * Active conduction system abnormalities * ECG abnormality that is medically relevant * Psychiatric conditions that prevent compliance with protocol or consent. * Pre-existing neuropathy grade 2 or higher or other serious neurologic toxicity that would significantly increase risk of complications from bevacizumab therapy * Serious medical or psychiatric illness likely to interfere with participation in this clinical study * Diagnosis or treatment for another malignancy within 3 years of enrollment, with the exception of any of the following: * Complete resected basal cell carcinoma * Squamous cell carcinoma of the skin * Any in situ malignancy * Low-risk prostate cancer after curative therapy PRIOR CONCURRENT THERAPY: * Prior decitabine or azacytidine for MDS or AML is allowed * Prior bortezomib allowed * More than 2 weeks since prior chemotherapy or radiotherapy (6 weeks for nitrosoureas or mitomycin C) * More than 14 days since prior and no concurrent investigational agents * No concurrent combination antiretroviral therapy for HIV-positive patients