• Male and female patients between the ages of 18-75.

• Patients with a histologic diagnosis of AML in morphological remission (\<5% bone marrow (BM) blasts) prior to allogeneic hematopoietic cell transplantation and very high-risk for relapse defined as: (i) Presence of measurable residual disease (MRD) by multicolor flow cytometry (MFC) prior to transplant and receiving a reduced intensity conditioning (RIC) or nonmyeloablative (NMA) regimen (ii) Presence of MRD by MFC at day +30 post-transplant (iii) All patients with monosomal karyotype (MK) and those with 17p/tumor protein p53 (TP53) mutated disease irrespective of MRD status and intensity of conditioning regimen.

• Adequate hematopoietic recovery after HCT, defined as:

‣ Absolute neutrophil count (ANC) \>= 1 x 10\^9/L without daily use of myeloid growth factors

⁃ Platelet count \>= 50 x 10\^9/L without platelet transfusion within 1 week

• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2

• Serum creatinine =\< 1.5 mg/dL or creatinine clearance greater or equal than 40 cc/min

• Serum bilirubin =\< 1.5 x upper limit of normal (ULN)

• Aspartate transaminase (AST) or alanine transaminase (ALT) =\< 2.5 x ULN

• Alkaline phosphatase =\< 2.5 x UL

• Negative serum or urine pregnancy test for women with reproductive potential.

⁃ A negative donor-specific antibody (DSA) assay (i.e., Micro-Flow Imaging (MFI) \<m3000) for recipients of any mismatched graft (including haploidentical) HCT.