Selinexor in Treating Patients With Intermediate- and High-Risk Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome After Transplant

Inclusion Criteria: * Signed, written informed consent in accordance with federal, local, and institutional guidelines * Patients underwent allo-SCT with intermediate risk and high risk AML and high risk MDS (defined by American Society for Blood and Marrow Transplantation \[ASBMT\] criteria), who are within 60 to 100 days after allo-SCT * There is no evidence of disease relapse at the time of screening, and minimal residual disease (MRD) is acceptable * Eastern Cooperative Oncology Group (ECOG) performance status of =\< 2 * Absolute neutrophil count (ANC) \> 1000 uL * Platelets \>= 20,000 without platelet transfusion * Creatinine clearance \> 30 cc/min calculated using the Cockcroft and Gault (1976) formula or measured * Total bilirubin =\< 2 mg/dl unless high indirect bilirubin is due to a congenital disorder * Transaminases (aspartate aminotransferase \[AST\] or alanine aminotransferase \[ALT\]) =\< 2.0 x upper limit of normal (ULN) * Prothrombin time (PT) and partial thromboplastin time (PTT) =\< 2 x ULN * Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures * It is important patients understand the need to use birth control while on this study; female patients of child-bearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening (\< 3 days prior to first dose), male patients with partners of childbearing potential must agree to use effective contraception during the study period and a period of 3 months after the last dose of study drug; for both male and female patients, effective methods of contraception must be used throughout the study and for three months following the last dose Exclusion Criteria: * Patients with acute GVHD grade II-IV * Treatment with any investigational agent within three weeks prior to first dose in this study * Major surgery within 2 weeks of first dose of study drug; patients must have recovered from the effects of any surgery performed greater than 2 weeks previously * Patient has a concurrent active malignancy under treatment * Unstable cardiovascular function: * Symptomatic ischemia, or * Uncontrolled clinically significant conduction abnormalities (i.e., ventricular tachycardia on antiarrhythmic agents are excluded; 1st degree atrioventricular (AV) block or asymptomatic left anterior fascicular block/right bundle branch block (LAFB/RBBB) will not be excluded), or * Congestive heart failure (CHF) NYHA class \>= 3, or * Myocardial infarction (MI) within 3 months * Uncontrolled infection requiring parenteral antibiotics, antivirals, or antifungals within one week prior to first dose; infections controlled on concurrent anti-microbial agents are acceptable, and anti-microbial prophylaxis per institutional guidelines are acceptable * Known active hepatitis B virus (HBV) or C virus (HCV) infection; or known to be positive for HCV ribonucleic acid (RNA) or HBsAg (HBV surface antigen) * Known human immunodeficiency virus (HIV) infection * Any medical condition which, in the investigator's opinion, could compromise the patient's safety * Patients unable to swallow tablets or patients with malabsorption syndrome, or any other disease significantly affecting gastrointestinal function