Pre-reinductive Decitabine and Vorinostat in Relapsed Lymphoblastic Lymphoma or Acute Lymphoblastic Leukemia

Inclusion Criteria

• •Diagnosis of lymphoblastic lymphoma or acute lymphoblastic leukemia with ≥ 5% blasts in the bone marrow (M2/M3) (with or without extramedullary disease) that meets 1 of the following criteria:
• •* Refractory disease/induction failure (failure to achieve initial remission after 2 lines of induction therapy)
• •* Relapsed disease (in first relapse or higher)
• •Central nervous system (CNS)-positive disease allowed
• •Karnofsky performance status (PS) 50-100% (for patients ≥ 16 years of age) OR Lansky PS 50-100% (for patients \< 16 years of age)
• •Life expectancy ≥ 8 weeks
• •Creatinine clearance ≥ 70 mL/min OR maximum serum creatinine based on age/gender as follows:
• •* 0.4 mg/dL (for patients 1 to 5 months of age)
• •* 0.5 mg/dL (for patients 6 to 11 months of age)
• •* 0.6 mg/dL (for patients 1 year of age)
• •* 0.8 mg/dL (for patients 2 to 5 years of age)
• •* 1.0 mg/dL (for patients 6 to 9 years of age)
• •* 1.2 mg/dL (for patients 10 to 12 years of age)
• •* 1.5 mg/dL (males) or 1.4 mg/dL (females) (for patients 13 to 15 years of age)
• •* 1.7 mg/dL (males) or 1.4 mg/dL (females) (for patients ≥ 16 years of age)
• •ALT \< 5 times upper limit of normal (ULN)
• •Total bilirubin ≤ 1.5 times ULN for age
• •LVEF ≥ 40% by ECHO/MUGA scan
• •Shortening fraction \> 29% by ECHO/MUGA scan
• •Able to swallow capsules
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception during and for 2 months after completion of study treatment
• •No untreated positive blood cultures or progressive infections as assessed by radiographic studies
• •No known allergy to any of the agents or their ingredients used in this study
• •* Patients with clinically significant prior allergies to pegaspargase may be treated with asparaginase-Erwinia, if available