Phase 2 Study of Atorvastatin Safety and Antitumor Effects in Non-Hodgkin's Lymphoma

Inclusion Criteria:

* \> 18 years old
* Disease criteria: Confirmed by Stanford Pathology to be one of the following Non-Hodgkin's Lymphoma (NHL) subtypes:

  * Chronic lymphocytic leukemia /small lymphocytic lymphoma (CLL/SLL)
  * Extranodal marginal zone B-cell lymphoma
  * Nodal marginal zone B-cell lymphoma
  * Splenic marginal zone B-cell lymphoma
* Treatment criteria

  * Untreated: watchful waiting currently appropriate (includes CLL stage 0) o OR
  * Prior treatment: watchful waiting currently appropriate o OR
  * Refractory disease
* Staging within 4 weeks prior to enrollment (SLL, marginal zone lymphoma)

  * CT chest (date)
  * CT abdomen (date)
  * CT pelvis (date) OR
* Staging within 4 weeks prior to enrollment (CLL: CT not required)

  * Total white blood cell count (WBC) (Value) (date)
  * Absolute lymphoma cell count (ALC) (Value) (date)
  * Measurable disease (Site) (Size) OR
  * CLL (only): elevated absolute lymphoma cell count
* Disease amenable to biopsy (must check at least one):

  * Circulating tumor cells
  * Positive bone marrow
  * Palpable involved site (such as lymph node) measuring \> 1.5 cm
* Eastern Cooperative Oncology Group performance status \<2 (Karnofsky \>60)
* Life expectancy of greater than 3 months
* Patients must have adequate organ and marrow function

  * Absolute neutrophil count \> 1,000/uL
  * Platelets \> 30,000/uL
  * Total bilirubin within normal institutional limits
  * Aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ratio \< 2.5 x institutional upper limit of normal
  * Creatinine within normal institutional limits OR creatinine clearance \> 60 mL/min/1.73 m² for patients with creatinine levels above institutional normal.
* Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Women of child-bearing potential must have negative BetaHCG at enrollment

Exclusion Criteria:

* Chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study
* Not recovered from adverse events due to agents administered more than four weeks earlier
* Has stable low grade lymphoma has had rituximab within 3 months Patient with relapsed or refractory disease has had rituximab within 1 month
* Not recovered from adverse events due to surgery performed 4 weeks earlier
* Receiving any other investigational agent. Known brain metastases
* Taken any statin within the past 6 months prior to enrollment in the trial
* Currently abuses alcohol
* Currently takes cyclosporin or gemfibrozil Patient has a prior history of rhabdomyolysis
* Has uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
* Pregnant: Patients are not excluded if they are breastfeeding at the time of enrollment, but breastfeeding should be discontinued if the mother is treated with atorvastatin.
* HIV-positive patients receiving combination anti-retroviral therapy