Panobinostat in Treating Patients With Relapsed or Refractory Non-Hodgkin Lymphoma

Inclusion Criteria

• Biopsy-proven relapsed or refractory non-Hodgkin lymphoma requiring treatment, who have failed, unable to tolerate, or refused other available active therapies; patients should not have other treatment options considered curative (NOTE: for patients with lymphoma without CNS involvement, a re-biopsy is necessary unless the patient has had a previous biopsy = = 2 cm or tumor cells in the blood >= 5 x 10^9/L; skin lesions can be used if the area is >= 2 cm in at least one diameter and photographed with a ruler
• The following disease types are eligible: transformed lymphomas: diffuse large B cell lymphoma, mantle cell lymphoma, follicular lymphoma grade III; precursor B lymphoblastic leukemia/lymphoma; mediastinal (thymic) large B-cell lymphoma; Burkitt lymphoma/leukemia; precursor T-lymphoblastic leukemia/lymphoma; primary cutaneous anaplastic large cell lymphoma; anaplastic large cell lymphoma - primary systemic type; small lymphocytic lymphoma/chronic lymphocytic leukemia; follicular lymphoma, grades 1, 2; extranodal marginal zone B-cell lymphoma of MALT type; nodal marginal zone B-cell lymphoma; splenic marginal zone B-cell lymphoma; peripheral T cell lymphoma, unspecified; anaplastic large cell lymphoma (T and null cell type); lymphoplasmacytic lymphoma (Waldenstrom Macroglobulinemia); CNS lymphoma; post transplant lymphoproliferative disorders; mycosis fungoides/Sezary syndrome; primary effusion lymphoma; blastic NK-cell lymphoma; adult T-cell leukemia/lymphoma; extranodal NK/T-cell lymphoma, nasal type; enteropathy-type T-cell lymphoma; hepatosplenic T-cell lymphoma; subcutaneous panniculitis-like T-cell lymphoma; angioimmunoblastic T-cell lymphoma; anaplastic large cell lymphoma - primary cutaneous type
• For lymphoplasmacytic lymphoma patients without measurable lymphadenopathy, measurable disease can be defined by both of the following criteria: bone marrow lymphoplasmacytosis with > 10% lymphoplasmacytic cells or aggregates, sheets, lymphocytes, plasma cells, or lymphoplasmacytic cells on bone marrow biopsy and quantitative IgM monoclonal protein > 1,000 mg/dL
• ANC >= 1000/uL
• Hgb >= 9 g/dl
• PLT >= 75,000/uL
• Total bilirubin = 1.5 x ULN the direct bilirubin must be normal
• AST = 3.0 g/dl
• Creatinine = = LLN and = = LLN
• Clinically euthyroid; patients are permitted to receive thyroid hormone supplements to treat underlying hypothyroidism
• Baseline MUGA or ECHO must demonstrate LVEF >= the lower limit of the institutional normal
• Ability to understand and the willingness to sign a written informed consent document
• Willingness to return to Mayo Clinic
• Life expectancy >= 12 weeks
• Willingness to provide blood and tissues samples for research studies as required by the protocol
• Negative pregnancy test done = 20mg of prednisone per day (or equivalent)
• Persistent toxicities >= grade 2 from prior chemotherapy or biological therapy regardless of interval since last treatment
• Patients with congenital long QT syndrome
• History or presence of sustained ventricular tachyarrhythmia (patients with a history of atrial arrhythmia are eligible but should be discussed with the study PI prior to enrollment)
• Any history of ventricular fibrillation or torsade de pointes
• Bradycardia defined as HR = 50 bpm
• Screening ECG with a QTcFredericia (QTcF) > 450 msec
• Right bundle branch block + left anterior hemiblock (bifascicular block)
• Patients with myocardial infarction or unstable angina = CTCAE Grade 2, malabsorption syndrome or small bowel resection) that would preclude use of oral medications
• Thrombolic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months
• Any severe and/or uncontrolled medical conditions or other conditions that, in the treating physician's opinion, could adversely impact their ability to participate in the study; patients on chronic oxygen therapy, those with liver disease such as cirrhosis, chronic hepatiti