Tipifarnib in Treating Patients With Anemia or Neutropenia and Large Granular Lymphocyte Leukemia

Inclusion Criteria:

* Diagnosis of T-cell-large granular lymphocyte (LGL) leukemia or natural killer (NK)-LGL leukemia associated with ≥ 1 of the following clinical manifestations:

  * Severe neutropenia (i.e., \< 500/mm³)
  * Neutropenia associated with recurrent infections, meeting 1 of the following criteria: one severe infection requiring hospitalization or at least 2 infections requiring antibiotic therapy
  * Symptomatic anemia with significant fatigue with a score of greater than 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Status Scale; dyspnea on exertion, but able to walk one flight of stairs without stopping (less than grade 1 respiratory symptoms); cardiac symptoms including worsening of angina or new onset of chest pain
  * Transfusion-dependent anemia
* Willing to discontinue use of MTX, Cy, or cyclosporine for 1 month prior to study entry
* T-cell-LGL leukemia must meet all of the following criteria: CD3+ and CD57+ cells \> 300/mm³ or CD8+ cells \> 650/mm³ by phenotypic studies of peripheral blood, evidence for clonal T-cell receptor gene rearrangement based on positive flow cytometric analysis, T-cell receptor (TCR)-γ chain polymerase chain reaction (PCR), TCR-Vβ PCR, or by Southern blot analysis
* NK-LGL leukemia must have CD56+ or CD16+ NK cells \> 750/mm³ by phenotypic studies of peripheral blood
* Life expectancy \> 2 years
* ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
* Fertile patients must use effective contraception prior to and during study
* Negative pregnancy test
* Normal kidney and liver function, as determined by the following laboratory results: total bilirubin less than or equal to 2.0 mg/dl; AST (SGOT) and ALT (SGPT) less than or equal to 2.5 times the upper limit of normal; and creatinine less than or equal to 2.0 mg/dl

Exclusion Criteria:

* Not pregnant or nursing
* No history of allergic reactions attributed to compounds of similar chemical or biologic composition to tipifarnib
* No allergies to imidazoles (e.g., clotrimazole, ketoconazole, miconazole, econazole, fenticonazole, isoconazole, sulconazole, tioconazole, or terconazole)
* No uncontrolled concurrent illness including, but not limited to, any of the following: ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, psychiatric illness or social situations that would limit study compliance
* No other serious medical illness that would limit survival to \< 2 years
* No other malignancy within the past 5 years except inactive nonmelanoma skin cancer or carcinoma in situ of the cervix
* Psychiatric illness that may interfere with study participation
* No other anticancer agents or therapies
* No concurrent antiretroviral therapy for HIV-positive patients
* No other concurrent investigational agents
* No prior tipifarnib or other inhibitors of MAPK signaling intermediates