Venetoclax to Improve Outcomes of Fractionated Busulfan Regimen in Patients With High-Risk AML and MDS

This study is testing whether adding venetoclax (a targeted drug that helps trigger cancer cell death) to a chemotherapy conditioning regimen (called fractionated busulfan) before a stem cell transplant can improve outcomes for patients with high-risk acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). **You may be eligible if...** - You are 18 to 70 years old - You have AML that is high-risk, not in full remission, or has residual cancer detectable on sensitive tests (MRD positive) - OR you have high-risk MDS - You are eligible for and are planning an allogeneic stem cell transplant **You may NOT be eligible if...** - You are over 70 years old - You have significant organ dysfunction (heart, lung, liver, or kidney) - You have active uncontrolled infection - You cannot tolerate the transplant conditioning regimen Talk to your doctor to see if this trial is right for you.