Individualized AML Treatment

Inclusion Criteria: * Documented informed consent of the participant and/or legally authorized representative. * Agreement to allow the use of archival tissue from diagnostic tumor biopsies * Age: ≥ 18 years * ECOG ≤ 3 (Appendix A) * Patients with histologically confirmed AML according to ICC or WHO criteria, and * Refractory/relapsed (R/R) to prior treatment with one or more regimens if adverse risk or two or more regimens if favorable/intermediate risk (Appendix B) * Sufficient bone marrow and/or peripheral blood sample (archival or fresh) to run the high throughput screening (HTS; Estimate sufficient if circulating blast count of 5,000 or greater or cellular marrow with greater than or equal to 20% blasts.) Otherwise, * Sufficient cells flushed from bone marrow biopsy, if bone marrow is not aspirable, OR * Extramedullary disease, if it is possible to obtain a fluid or biopsy sample from that location * Expected survival is greater than 100 days. * Fully recovered from the acute toxic effects (except alopecia) to ≤ Grade 1 to prior anti-cancer therapy Exclusion Criteria: * Treatment with any chemotherapeutic agent necessary to control AML burden is permitted between day -18 and -1. * Must not have received or planning to receive live vaccine while being on study * Patients with t(15;17) karyotypic abnormality or acute promyelocytic leukemia (FAB class M3-AML) * Active central nervous system (CNS) disease (OK if treated and responding) * Active graft vs host disease (GVHD) * Unstable cardiac disease as defined by one of the following: * Cardiac events such as myocardial infarction (MI) within the past 6 months * Uncontrolled atrial fibrillation or hypertension * Clinically significant uncontrolled illness * Uncontrolled active infection * Females only: Pregnant or breastfeeding * Any other condition or active malignancy that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures. * Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics).