Lenalidomide in HTLV-1 Adult T-Cell Leukemia

Inclusion Criteria

• •Age ≥18 years at the time of signing the informed consent form.
• •Able to adhere to the study visit schedule and other protocol requirements.
• •Relapsed or refractory HTLV-1 associated Adult T-cell Leukemia/Lymphoma (Acute and lymphoma subtypes)
• •All previous cancer therapy, including radiation, hormonal therapy and surgery, must have been discontinued at least 4 weeks prior to treatment in this study.
• •ECOG performance status of ≤ 2 at study entry (see Appendix C).
• •Laboratory test results within these ranges:
• •* Absolute neutrophil count ≥ 1000/mm³
• •* Platelet count ≥ 50,000 /mm³
• •* Calculated creatinine clearance of ≥ 30 mL/min by Cockcroft-Gault formula (Appendix J). Patients with calculated creatinine clearance ≥ 30 mL/min and \< 60 mL/min will have a reduced starting dose of lenalidomide (see Section 5.4.2).
• •* Total bilirubin ≤ 1.5 x ULN
• •* AST (SGOT) and ALT (SGPT) ≤ 3 x ULN.
• •Disease free of prior malignancies for ≥ 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "insitu" of the cervix or breast.
• •Females of childbearing potential (FCBP)† must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior to and again within 24 hours of starting lenalidomide and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide. FCBP must also agree to ongoing pregnancy testing. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy. All patients must be counseled at a minimum of every 28 days about pregnancy precautions and risks of fetal exposure. See Appendix A: Risks of Fetal Exposure, Pregnancy Testing Guidelines and Acceptable Birth Control Methods, AND also Appendix B: Education and Counseling Guidance Document.
• •Patients at high risk for DVT/PE must be able to take aspirin (81 or 325 mg) daily as prophylactic anticoagulation (patients intolerant to ASA may use warfarin or low molecular weight heparin).