Vorinostat After Stem Cell Transplant in Treating Patients With High-Risk Lymphoma

DISEASE CHARACTERISTICS:

• Must have received a BEAM (cytarabine, etoposide, melphalan, carmustine)-conditioned autologous stem cell transplantation for any of the following high-risk lymphomas:

  • Diffuse large B-cell lymphoma as defined by:

    • Induction failure but with response to salvage therapy
    • Relapse less than one year after completion of induction therapy
    • Elevated lactate dehydrogenase (LDH) at relapse
    • Stage III/IV disease at relapse
    • Positive PET scan after induction or salvage therapy
    • Age ≤ 75 and ≥ 60 years

  • Follicular lymphoma as defined by:

    • Progressive disease after two or more prior regimens
    • Transformed to aggressive lymphoma but still chemotherapy sensitive
    • Not felt to be a good candidate for an allogeneic transplantation

  • Hodgkin lymphoma as defined by:

    • Primary refractory disease
    • Relapse less than one year after completion of induction therapy
    • Relapse with PET-positive disease after salvage therapy
    • Relapsed refractory and not felt to be a good candidate for an allogeneic transplantation

  • Mantle cell lymphoma

    • Chemotherapy-sensitive disease after induction therapy
    • Chemotherapy-sensitive relapsed disease and not felt to be a good candidate for an allogeneic transplantation

  • T-cell non-Hodgkin lymphoma (NHL)

    • Peripheral T-cell lymphoma not otherwise specified and one or more of the following at diagnosis:

      • High LDH
      • Marrow involvement
      • Age > 60 years
      • Low platelet count
      • Relapsed chemotherapy-sensitive disease
    • Angioimmunoblastic lymphadenopathy with dysproteinemia
    • Anaplastic lymphoma kinase-negative anaplastic NHL
    • Enteropathy-associated T-cell NHL
    • Natural killer (NK)/T-cell NHL and stage III/IV disease at diagnosis
    • NK blastic NHL

PATIENT CHARACTERISTICS:

• ECOG/WHO performance status 0-2
• ANC ≥ 1,000/μL
• Platelet count ≥ 75,000/μL
• Total bilirubin ≤ 1.5 mg/dL
• AST/ALT ≤ 2 x upper limit of normal (ULN)
• Serum creatinine ≤ 1.5 x ULN OR creatinine clearance ≥ 50 mL/min
• No severe or uncontrolled systemic illness
• Patients must be able to swallow capsules
• Negative pregnancy test
• Not pregnant or nursing
• Fertile patients must use at least two adequate barrier methods of contraception during study and for 90 days after completion of study therapy
• No other malignancy within the past 5 years other than nonmelanoma skin cancer, carcinoma in situ of the cervix, or a malignancy considered by their physician to be at less than 30% risk of relapse
• No congenital long QT syndrome
• No significant history of uncontrolled cardiac disease (i.e., uncontrolled hypertension, unstable angina, myocardial infarction within the past 6 months, or uncontrolled congestive heart failure)
• No active bacterial, fungal, or viral infection
• No known HIV infection
• No active hepatitis B and/or hepatitis C infection
• No other medical condition, including mental illness or substance abuse, deemed by the Investigator(s) to interfere with a patient's ability to sign informed consent, cooperate and participate in the study, or interfere with the interpretation of the results

PRIOR CONCURRENT THERAPY:

• Recovered from the majority of the toxicities from the autologous transplantation (must have returned to their pretransplant baseline or have no greater than grade I extramedullary toxicity [CTCAE 3.0])
• No prior treatment with a histone deacetylase (HDAC) inhibitor (e.g., depsipeptide, MS-275, LAQ-824, belinostat, valproic acid)
• More than 4 weeks since prior and no concurrent class Ia, Ib, or Ic antiarrhythmic drugs
• No other concurrent antineoplastic chemotherapy or biologic therapy

• No concurrent radiotherapy, unless for local control of bone pain

  • Irradiated area for pain management should be as small as possible and lesions within the irradiated field cannot be used for response
• No concurrent use of complementary or alternative medicines that would confound the interpretation of toxicities and antitumor activity of vorinostat (SAHA)