Safety Study of BTK Inhibitor, DTRMWXHS-12, Used Singly or in Combination, in CLL and B-cell Lymphomas

Inclusion Criteria:

- Patients with a diagnosis of chronic lymphocytic leukemia (CLL) or other B-cell
neoplasms including small lymphocytic lymphoma (SLL), mantle cell lymphoma (MCL),
marginal zone lymphoma (MZL) and follicular B-cell non-Hodgkin's lymphoma (FL) who
have no available approved therapies.

- Age > 18 years.

- Life expectancy greater than 12 weeks.

- Patients must have an ECOG (Eastern Cooperative Oncology Group) performance status 0
or 1.

- Patients must provide written informed consent.

- Ability to swallow and retain capsules.

- Absence of uncontrolled intercurrent illnesses, including uncontrolled infections,
cardiac conditions, or other organ dysfunctions.

- Women of child-bearing potential must have a negative serum or urine pregnancy test.

- Women of child-bearing potential must agree to use 2 reliable methods of contraception
beginning 4 weeks prior to the initiation of treatment, during therapy, and for at
least 4 weeks after the last drug administration.

- Men must agree to use a latex or synthetic condom during sexual contact with a
pregnant female or a female who can become pregnant, for the duration of the study and
for at least 4 weeks after the last drug administration, even if they have undergone a
successful vasectomy.

Exclusion Criteria:

- Received previous chemotherapy, immunotherapy, radiotherapy or any other
investigational therapy within 21 days or 5 half-lives for targeted therapies prior to
this study entry.

- Patients with active infections requiring intravenous (IV) antibiotic/antiviral
therapy are not eligible for entry onto the study until resolution of the infection;
patients on prophylactic antibiotics, antifungals or antivirals are acceptable

- Pregnant or lactating individuals.

- Impaired hepatic or renal function as demonstrated by any of the following laboratory
values:

1. AST or ALT > 2.5 x ULN

2. Total bilirubin > 1.5 x ULN (Patients with a history of Gilbert's syndrome may
participate if total bilirubin is less than or equal to 1.5 x ULN and the AST/ALT
and alkaline phosphatase meet the protocol-specified levels for eligibility)

3. Alkaline phosphatase > 2.5 x ULN

4. Glomerular filtration rate (GFR) < 50 mL/min, as assessed using the standard
methodology at the investigating center (i.e. Cockroft-Gault), or serum
creatinine > 1.5 x ULN

- INR > 1.5 or other evidence of impaired hepatic synthesis function.

- Persisting (> 8 weeks) severe pancytopenia due to hematologic disorder or due to
previous therapy rather than disease (ANC < 0.5 x 109/L or platelets < 30 x 109/L) -
to be confirmed via bone marrow biopsy, as part of normal clinical care, prior to
signing of consent.

- Previous allogeneic bone marrow transplant are restricted, unless there is no evidence
of acute or chronic graft versus host disease.

- CNS involvement with malignancy.

- Current malignancies of another type, with the exception of adequately treated in situ
cervical cancer and basal cell skin cancer, squamous cell carcinoma of the skin or
other malignancies with no evidence of disease for 2 years or more.

- Known history of HIV, HBV or HCV infection.

- Documented or known bleeding disorder.

- Requirement for anticoagulation treatment that increases INR or aPTT above the normal
range (low molecular weight heparin and heparin line flush allowed).

- Patient is receiving any azole.

- Patients with a significant cardiovascular disease or condition, including:

- Myocardial infarction within 6 months of study entry

- NYHA Class III or IV heart failure, or reduced LVEF <50%

- Uncontrolled dysrhythmias or poorly controlled angina.

- History of serious ventricular arrhythmia (VT or VF, ≥ 3 beats in a row) and/or
risk factors (e.g., heart failure, hypokalemia, family history of Long QT
Syndrome)

- Baseline prolongation of QT/QTc interval (repeated demonstration of QTc ≥ 450
msec for men and 470 msec for women, or LVEF ≤ 40% by MUGA or ECHO).