 I. To determine the complete remission CR cytogenic complete remission CRc morphologic complete remission with incomplete blood count recovery CRi rate of carboplatin and topotecan; flavopiridol, mitoxantrone and cytosine arabinoside and sirolimus, mitoxantrone, etoposide and cytosine arabinoside in adult patients with refractory or relapsed acute myeloid leukemia AML. 