Ruxolitinib in Treating Patients with Relapsed or Refractory T-cell or NK Cell Lymphoma

Inclusion Criteria

• Pathologically confirmed T or NK cell lymphoma at the enrolling institution; for cutaneous T-cell non-Hodgkin lymphoma (CTCL), patients with stage IB disease or greater are eligible
• Relapse or refractory disease after at least 1 systemic therapy except for T-cell-prolymphocytic leukemia (T-PLL), large granular lymphocyte (LGL), or T-cell Lymphoproliferative diseases with JAK2 fusion untreated patients may be allowed after discussion with principal investigator (P.I.)
• Age >= 18
• Eastern Cooperative Oncology Group (ECOG) =< 2
• Measurable disease defined by: * Lugano classification for systemic lymphoma or * Atypical and or malignant lymphocytes quantifiable by flow cytometry or morphology in blood or bone marrow or * Modified severity-weighted assessment tool (mSWAT) > 0 or Sezary count >= 1000 cells/uL for CTCL
• Previous systemic anti-cancer therapy for T-cell lymphoma must have been discontinued at least 2 weeks prior to treatment; * Glucocorticoids aimed at controlling lymphoma-related symptoms are allowed as long as they are tapered down to 20 mg or less by the time of ruxolitinib initiation * Topical steroids for CTCL are permitted
• Absolute neutrophil count (ANC) >= 1.0/mm^3 or ANC >= 0.5/mm^3 (if patient has baseline neutropenia due to lymphoma)
• Platelets >= 100 x 10^9/L or >= 50 x 10^9/L (if related to lymphoma)
• Hemoglobin (Hgb) >= 8 g/dL
• Patients with LGL or T-PLL are not required to meet a minimum ANC or hemoglobin value for eligibility
• Total bilirubin =< 1.5 x upper limit of normal (ULN) or =< 3 x ULN if documented hepatic involvement with lymphoma, or =< 5 x ULN if history of Gilbert's syndrome
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3 x ULN; =< 5 if due to lymphoma involvement * Patients with elevated bilirubin for reasons other than liver dysfunction (e.g. hemolysis) are eligible after discussion with Memorial Sloan Kettering (MSK) principal investigator (PI)
• Creatinine clearance >= 30 mL/min; creatinine clearance of 15-29 mL/min will be allowed as long as baseline platelets are >= 150 x 10^9/L
• For patients with positive hepatitis B core antibody or surface antigen, hepatitis B polymerase chain reaction (PCR) must be negative and prophylaxis with entecavir or equivalent is required
• Patients with human immunodeficiency virus (HIV) are allowed provided that they are on anti-retroviral treatment with no active infections

Exclusion Criteria

• Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form
• Uncontrolled concurrent illness including, but not limited to, ongoing or active infection, uncontrolled diabetes, clinically significant pneumonitis, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Eastern Cooperative Oncology Group (ECOG) performance status > 2
• Prior therapy with ruxolitinib
• Receiving systemic therapy for another primary malignancy (other than T-cell lymphoma) * Patients with more than one type of lymphoma may be enrolled after discussion with the Memorial Sloan-Kettering (MSK) principal investigator * Adjuvant or maintenance therapy to reduce the risk of recurrence of other malignancy (other than T-cell lymphoma) is permissible after discussion with the MSK principal investigator
• Women of reproductive potential* must have a negative serum beta human chorionic gonadotropin (beta-HCG) pregnancy test * A female of reproductive potential is a sexually mature female who: has not undergone a hysterectomy or bilateral oophorectomy; or has not been naturally postmenopausal for at least 24 consecutive months (i.e. has had menses at any time during the preceding 24 consecutive months)