∙ In order to be eligible to participate in this study, a patient must meet all of the following criteria:

• Patients with: a diagnosis of AML and related precursor neoplasms according to ICC-2022 classification (excluding acute promyelocytic leukaemia) (appendix A). Patients may have had previous treatment with erythropoiesis stimulating agents (ESA) for an antecedent phase of MDS. ESAs must be stopped at least two weeks before registration.

• Patients 18 years and older who are considered not fit for intensive chemotherapy or who decline the option of intensive chemotherapy.

• WHO performance status 0, 1 or 2 (appendix E).

• Adequate renal and hepatic functions unless clearly disease related as indicated by the following laboratory values:

‣ Adequate renal function as demonstrated by a creatinine clearance ≥ 30 mL/min; calculated by the Cockcroft Gault formula or measured by 24 hours urine collection.

⁃ Serum bilirubin ≤ 3 x upper limit of normal (ULN), unless considered AML-related or due to Gilbert's syndrome.

⁃ Alanine transaminase (ALT) ≤ 3 x ULN, unless considered AML-related.

• Male subjects who are sexually active, must agree, from Study Day 1 until at least 90 days after the last dose of study drug, to practice the protocol specified contraception. Male subjects must agree to refrain from sperm donation from initial study drug administration through at least 90 days after the last dose of study drug.

• Female subjects must be either postmenopausal defined as: Age \>55 years with no menses for ≥12 months, without an alternative medical cause. OR willing and able to use adequate contraception during and until 180 days after the last protocol treatment.

• Written informed consent.

• Patient is capable of giving informed consent.

• Patient agrees not to participate in another interventional study while on treatment without approval of the (co-) Principal Investigator.