Inclusion Criteria
DISEASE CHARACTERISTICS:
- Diagnosed with advanced hematologic malignancies meeting the following criteria:
- Multiple myeloma
- Received ≥ 2 lines of prior chemotherapy (induction chemotherapy followed
by high-dose chemotherapy and autologous stem cell transplant with or
without maintenance therapy is considered one line of therapy)
- Acute myeloid leukemia
- Acute lymphoblastic leukemia
- Diffuse large B-cell lymphoma
- Hodgkin lymphoma
- Mantle cell lymphoma
- Mature T- and NK-cell neoplasms restricted to the following WHO-defined
entities:
- T-cell prolymphocytic leukemia
- T-cell large granular lymphocytic leukemia
- Aggressive NK-cell leukemia
- Adult T-cell leukemia/lymphoma
- Extranodal NK/T-cell lymphoma (nasal type)
- Mycosis fungoides
- Sézary syndrome
- Primary CD30-positive T-cell lymphoproliferative disorders
- Primary cutaneous anaplastic large cell lymphoma
- Primary cutaneous gamma-delta T-cell lymphoma
- Peripheral T-cell lymphoma (not otherwise specified)
- Angioimmunoblastic T-cell lymphoma
- Anaplastic large cell lymphoma (ALK-positive/ALK-negative)
- Grade 3B follicular lymphoma
- Relapsed following or progressed during standard therapy
- Meeting the following criteria:
- Standard intensive therapy is not feasible
- Current disease state for which there is no standard effective therapy
- Refused standard therapy where no curative option exists
- Measurable disease, defined as the following:
- Myeloma: measurable serum monoclonal protein > 1 g/dL for IgG, or > 0.5 g/dL for
IgA, IgM or IgD, or difference between involved and uninvolved free light chain
levels in serum > 100 mg/L
- Lymphoma: must have ≥ 1 lesion measurable by CT (longest diameter ≥ 15 mm)
- Acute leukemia: ≥ 20% blasts in bone marrow or in peripheral blood (≥ 200/mL
blasts in peripheral blood)
- No HIV-associated lymphoma
PATIENT CHARACTERISTICS:
- WHO performance status 0-2
- Absolute neutrophil count ≥ 1,500/mm³
- Platelet count ≥ 75,000/mm³ (if bone marrow impairment, ≥ 20,000/mm^3)
- Hemoglobin > 80 g/L (if considered to be caused by the underlying hematologic
malignancy or bone marrow impairment, > 80 g/L after transfusion)
- Bilirubin ≤ 1.5 times upper limit of normal (ULN) (if suspected hemolysis, direct
bilirubin ≤ 1.5 times ULN)
- ALT ≤ 2.5 times ULN
- Calculated creatinine clearance > 30 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 12 months after
completion of study treatment
- Willing and capable to comply with an oral regimen
- Capable of understanding information given by the investigator on the trial
- Able to adhere and remain in geographic proximity to allow proper staging, treatment,
and followup
- No other non-hematologic malignancy within the past 5 years, except adequately
treated cervical carcinoma in situ or localized nonmelanoma skin cancer
- No known chronic hepatitis B or C infection or known HIV infection
- No serious underlying medical condition (at the judgment of the investigator) which
would impair the ability of the patient to participate in the trial, including any of
the following:
- Active autoimmune disease
- Uncontrolled diabetes
- Ongoing or active infection
- Symptomatic congestive heart failure
- Unstable angina pectoris
- Cardiac arrhythmia
- Psychiatric disorder
- No myocardial infarction within the past 6 months
- No polyneuropathy > grade 1 significantly interfering with activities of daily living
or painful polyneuropathy
- No known hypersensitivity to trial drugs or hypersensitivity to any other component
of the trial drugs
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No more than 4 prior lines of chemotherapeutic regimens (induction chemotherapy
followed by high-dose chemotherapy and autologous stem cell transplant with or
without maintenance therapy is considered one line of therapy)
- More than 30 days since prior treatment in a clinical trial
- More than 30 days since prior and no concurrent chemotherapy or biologic agents
- For patients with acute leukemia, hydroxyurea may be given up to 48 hours before
first administration of the trial treatment, and low dose cytarabine (up to 20
mg/m^2) and mitoxantrone up to 20 mg up to 14 days before first dosing
- At least 1 week since prior and no concurrent CYP3A4 modulators
- No concurrent other experimental drugs
- No concurrent radiotherapy
- No concurrent antineoplastic therapy with chemotherapeutic or biologic agents