Tipifarnib in Treating Patients With Anemia or Neutropenia and Large Granular Lymphocyte Leukemia

Inclusion Criteria

• •Diagnosis of T-cell-large granular lymphocyte (LGL) leukemia or natural killer (NK)-LGL leukemia associated with ≥ 1 of the following clinical manifestations:
• •* Severe neutropenia (i.e., \< 500/mm³)
• •* Neutropenia associated with recurrent infections, meeting 1 of the following criteria: one severe infection requiring hospitalization or at least 2 infections requiring antibiotic therapy
• •* Symptomatic anemia with significant fatigue with a score of greater than 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Status Scale; dyspnea on exertion, but able to walk one flight of stairs without stopping (less than grade 1 respiratory symptoms); cardiac symptoms including worsening of angina or new onset of chest pain
• •* Transfusion-dependent anemia
• •Willing to discontinue use of MTX, Cy, or cyclosporine for 1 month prior to study entry
• •T-cell-LGL leukemia must meet all of the following criteria: CD3+ and CD57+ cells \> 300/mm³ or CD8+ cells \> 650/mm³ by phenotypic studies of peripheral blood, evidence for clonal T-cell receptor gene rearrangement based on positive flow cytometric analysis, T-cell receptor (TCR)-γ chain polymerase chain reaction (PCR), TCR-Vβ PCR, or by Southern blot analysis
• •NK-LGL leukemia must have CD56+ or CD16+ NK cells \> 750/mm³ by phenotypic studies of peripheral blood
• •Life expectancy \> 2 years
• •ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
• •Fertile patients must use effective contraception prior to and during study
• •Negative pregnancy test
• •Normal kidney and liver function, as determined by the following laboratory results: total bilirubin less than or equal to 2.0 mg/dl; AST (SGOT) and ALT (SGPT) less than or equal to 2.5 times the upper limit of normal; and creatinine less than or equal to 2.0 mg/dl