Fenretinide in Treating Patients With Refractory or Relapsed Hematologic Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed diagnosis of 1 of the following hematologic malignancies:

  • Non-Hodgkin's lymphoma (NHL)
  • Hodgkin's lymphoma
  • Multiple myeloma
  • Acute lymphoblastic leukemia
  • Acute myeloid leukemia

  • Chronic hematologic malignancy with a poor prognosis (e.g., failed 3 prior standard therapies), including any of the following:

    • Chronic lymphocytic leukemia
    • Chronic myelogenous leukemia
    • Indolent NHL
    • Myeloproliferative disorders

• Refractory or relapsed disease, as defined by 1 of the following:

  • Resistant to standard therapy for refractory or relapsed disease
  • Progressed after standard therapy for advanced disease
• No effective treatment exists
• Measurable or evaluable disease

• No active CNS disease

  • Previously treated leptomeningeal disease or brain metastases allowed provided there is no evidence of remaining cancer by positron-emission tomography, MRI, or spinal fluid cytology

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• ECOG 0-2

Life expectancy

• At least 3 months

Hematopoietic

• Absolute neutrophil count ≥ 1,500/mm^3 (unless due to bone marrow involvement of disease)
• Platelet count ≥ 75,000/mm^3 (unless due to bone marrow involvement of disease)
• Hemoglobin ≥ 8.0 g/dL (transfusion allowed)
• No coagulation disorders

Hepatic

• AST and ALT < 2.5 times upper limit of normal (ULN) (≤ 5 times ULN for patients with liver metastasis)
• Bilirubin ≤ 1.5 times ULN

Renal

• Creatinine ≤ 1.5 times ULN

Cardiovascular

• No major cardiovascular disease

Pulmonary

• No major respiratory disease

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective double-method contraception prior to study entry, during study, and for at least 6 months after study participation
• No uncontrolled systemic infection
• No uncontrolled hypertriglyceridemia (i.e., triglyceride level > 500 mg/dL)
• No known HIV positivity
• No known allergy to egg products
• No known familial hyperlipidemia disorders
• No previously undiscovered hypertriglyceridemia
• No poorly controlled diabetes

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• More than 2 weeks since prior chemotherapy except hydroxyurea

  • No concurrent hydroxyurea during study drug administration
• No other concurrent anticancer chemotherapy

Endocrine therapy

• No concurrent hormone-ablative agents
• No concurrent steroids
• No concurrent tamoxifen or any of its analogues

Radiotherapy

• No prior cranial radiotherapy
• More than 2 weeks since prior radiotherapy

Surgery

• More than 20 days since prior surgery except for biopsy

Other

• Recovered from all prior therapy
• More than 2 weeks since prior investigational agents
• No other concurrent investigational agents
• No other concurrent antineoplastic therapy
• No other concurrent antioxidants
• No concurrent herbal or other alternative therapies

• No concurrent vitamin supplements (e.g., vitamin A, ascorbic acid, or vitamin E)

  • Standard dose multivitamin allowed

• No other concurrent medications that may act as modulators of intracellular ceramide levels or ceramide cytotoxicity, sphingolipid transport, or p-glycoprotein or multidrug resistance protein 1 (MRP1) drug/lipid transporters, including any of the following:

  • Cyclosporine or any of its analogues
  • Verapamil
  • Ketoconazole
  • Chlorpromazine
  • Mifepristone
  • Indomethacin
  • Sulfinpyrazone

• No concurrent medications that may cause pseudotumor cerebri, including any of the following:

  • Tetracycline
  • Nalidixic acid
  • Nitrofurantoin
  • Phenytoin
  • Sulfonamides
  • Lithium
  • Amiodarone
• No concurrent medication to control hypertriglyceridemia