This is a phase I study of temsirolimus (Torisel) combined with dexamethasone,
cyclophosphamide and etoposide in patients with relapsed acute lymphoblastic leukemia (ALL),
lymphoblastic lymphoma (LL) or peripheral T-cell lymphoma (PTL).
Studies have shown that mTOR inhibitors (MTI) inhibit growth of pre-B and T-cell ALL cell
lines in vitro and in ALL xenograft models. The MTI temsirolimus was chosen for use in this
study due to its weekly intravenous dosing, its more predictable blood levels, and
availability of a single-agent pediatric MTD and its sustained biologic effect due to
conversion to sirolimus. This study will determine the maximum tolerated dose of
temsirolimus that can given in combination with dexamethasone, cyclophosphamide and
etoposide in relapsed ALL, LL or PTL. A standard 3-patient cohort dose-escalation design
will be used. Response to treatment will be evaluated. Biology tests will be done to
evaluate minimal residual disease (MRD), temsirolimus' effect on glucocorticoid resistance,
and mTOR inhibition.