Azacitidine and Abatacept in Relapsed or Refractory T-Cell Lymphoma

Inclusion Criteria

• •1. Participants must have a histologically or cytologically confirmed T-cell lymphoma confirmed by the Laboratory of Pathology (LP), NCI. The one of the following T-cell lymphomas are included:
• •* Peripheral T-cell lymphoma not otherwise specified (PTCL, NOS)
• •* Angioimmunoblastic T-cell lymphoma (AITL)
• •* T-follicular helper (TFH) lymphoma
• •* Anaplastic large cell lymphoma (ALCL)
• •* Enteropathy-associated T-cell lymphoma (EATL)
• •* Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL)
• •* Adult T-cell leukemia/lymphoma (ATLL)
• •* Other T-cell lymphoma (TCL)
• •2. Participants must have a disease that is relapsed or refractory after initial systemic treatment.
• •3. Participants must have evaluable disease on screening imaging or by laboratory assessment.
• •4. Age \>= 18 years.
• •5. ECOG performance status \<= 2.
• •6. Participants must have adequate organ and marrow function as defined below:
• •* Absolute neutrophil count (ANC) / \>= 1,000 cells/mcL OR \>= 500 cells/mcL if bone marrow involvement with lymphoma
• •* Platelets / \>= 50,000 cells/mcL OR \>= 25,000 cells/mcL if bone marrow involvement with lymphoma
• •* Hemoglobin / \>= 8 g/dL (transfusions permitted)
• •* Renal function / Serum creatinine \<= 2 mg/dL OR Glomerular filtration rate (GFR) \>= 40 mL/min/1.73 m\^2 as estimated by the Modification of Diet in Renal Disease (MDRD).
• •Note: there is no limit if involved by lymphoma.
• •If not on target, a 24-hour urine creatinine clearance can be used to directly measure creatinine clearance.
• •* Total bilirubin / \<= 1.5 x upper limit of normal (ULN)
• •* Aspartate Aminotransferase (AST) / \<= 3.0 x ULN
• •* Alanine Aminotransferase (ALT) / \<= 3.0 x ULN
• •* Prothrombin time (PT) / \<1.5 x ULN
• •* Activated partial thromboplastin time (aPTT) / \<1.5 x ULN; \< 5.0 x ULN if the aPTT is prolonged because of a positive Lupus Anticoagulant
• •International normalized ratio (INR) / \<1.5 x ULN
• •7. Participants, seropositive for human immunodeficiency virus (HIV), must have an undetectable HIV viral load.
• •8. Participants, seropositive for hepatitis C virus (HCV) infection, must have been treated and have an undetectable HCV viral load.
• •9. Participants who are hepatitis B core antibody (HBcAb) positive must have a hepatitis B virus (HBV) viral load result \<100 IU/mL. Note: participants who are hepatitis B surface antigen (HBsAg) positive are excluded.
• •10. Participants with detectable Epstein-Barr virus (EBV) or Cytomegalovirus (CMV) by polymerase chain reaction will be eligible provided they do not have end organ dysfunction from EBV or CMV infection.
• •11. Participants with pulmonary disease such as chronic obstructive pulmonary disease and non-infectious liver disease who otherwise meet the requirements.
• •12. Women of child-bearing potential (WOCBP) must agree to use effective methods of contraception (barrier, hormonal, surgical sterilization, abstinence) during the study treatment and for 6 months after the completion of the study treatment. Note: WOCBP is defined as any woman who has experienced menarche and who has not undergone successful surgical sterilization or who is not postmenopausal.
• •Men able to father a child must agree to use an effective method of contraception (barrier, surgical sterilization, abstinence) during the study treatment and for 3 months after the completion of the study treatment. These men must not freeze or donate sperm within the same period.
• •13. Nursing participants must be willing to discontinue nursing from study treatment initiation through six (6) months after the last dose of the study drug(s).
• •14. Ability of the participant to understand and the willingness to sign a written informed consent document.