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Mejais is a bad item in general since whether you like it or not you will probably die in a team fight and that makes the mejais completely useless. Morellos evil tome isn't that strong of an item either since dfg outclasses it with its active. Rylais crystal scepter isnt that strong on malz b/c none of his spells gets the full proc on it.
A good item for health would be rod of ages especially because the catalyst makes the laning phase much easier. The amp tome start is not very strong since you wont be casting all of your spells early
Also, isn't Fortify out of the game now? And since Malzahar can't jungle for ****, i suggest you move smite lower in the list.
Runes: So Magic Pene marks,yellow mana regen, blue Ap per/lvl , Quints +starting ap or magic pene.
Because of ur masteries what ur loosing:
10% magic pene.
3% more ability power
Targets below 40% hp +6% dmg of all source.
Items:
remove amplify tome as starting item, instead 3 pots + boots / dora. (Depend on what will buy enemy champ )
remove mejaj, add catalyst,
remove Morello's Evil Tome, add instead of it, banshee,Zhonya, Abysal Scepter.
Why ? those 3 items will give u hp,m. ressit,armor to fight fed champs, if ad carry is fed i would suggest zhonya/banshee, if AP , Abyssal/banshee.
Morello, why u dont need it ? U have utility masteries.. why ur still buying cdr, and mana regen, totally useless. :)
Thats it, i do not ment to offend u, just showing u a better paying off way :)
BoA Razjel
Good job and keep up the good work!