p53/p16-Independent Epigenetic Therapy With Oral Decitabine/Tetrahydrouridine for Refractory/Relapsed Lymphoid Malignancies

Primary objective: To determine the objective response rate to oral THU-Dec in patients with
3 separate biologic subsets of refractory/relapsed lymphoid malignancies:

1. T-cell lymphoma,

2. Aggressive B cell lymphoma,

3. indolent B-cell lymphoma .

Secondary objectives:

(i) To evaluate the toxicity of oral THU-Dec in these patients; (ii) To evaluate hypotheses
regarding mechanisms of resistance and predictive biomarkers.

Inclusion Criteria:

- Histologically or cytologically-proven T- or B-cell lymphoma

- Subjects must have received 1 or more prior therapies for this disease and have had
stable disease or progressive disease based upon the criteria from the Revised
Response Criteria for Malignant Lymphoma78, or intolerable toxicities precluding
further therapy with a prior regimen

- Subjects must have measurable disease per Revised Response Criteria for Malignant
Lymphoma78

- ECOG performance status 0 - 2

- Adequate organ function as defined by the following criteria:

- Serum aspartate transaminase (AST; serum glutamic oxaloacetic transaminase
[SGOT]) and serum alanine transaminase (ALT; serum glutamic pyruvic transaminase
[SGPT]) ≤ 2.5 x laboratory upper limit of normal (ULN)

- Total serum bilirubin ≤ 2.0 x ULN (except if Gilbert's disease)

- Absolute neutrophil count (ANC) ≥ 1500/uL

- Platelets ≥ 50,000/uL

- Hemoglobin ≥ 8.0 g/dL (transfusion permitted)

- Serum calcium ≤ 12.0 mg/dL

- Serum Creatinine ≤ 3.0 mg/dL

- Patients with history of CNS lymphoma can be enrolled if the CNS disease has been
controlled with therapy for a minimum of 4 weeks. Brain MRI is not required for
eligibility.

- Subjects must have the ability to understand and the willingness to sign a written
informed consent document.

Exclusion Criteria:

- Life expectancy ≤ 4 months in the judgment of the treating clinician

- Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome
(AIDS)-related illness (HIV-positive subjects on combination antiretroviral therapy
are ineligible because of the potential for pharmacokinetic interactions with oral
THU-Dec. Appropriate studies will be undertaken in subjects receiving combination
antiretroviral therapy when indicated.

- Pregnancy or breastfeeding (pregnant or breastfeeding women are excluded from this
study because oral THU-Dec has the potential for teratogenic or abortifacient effects.
Because there is an unknown, but potential, risk for adverse events in nursing infants
secondary to treatment of the mother with oral THU-Dec, breastfeeding should be
discontinued if the mother is treated with oral THU-Dec.

- Other severe acute or chronic medical or psychiatric conditions or laboratory
abnormality that may increase the risk associated with study participation or study
drug administration, or may interfere with the interpretation of study results, and in
the judgment of the investigator would make the patient inappropriate for entry into
this study.

- Receiving other investigational agent