Pharmacodynamic (PD) Study of Intranodal Adenovirus-CD154 (Ad-ISF35) in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL)

Inclusion Criteria:

Diagnosis of B-cell CLL/SLL including

Lymphocytosis of monoclonal B-cells co-expressing ≥ one B-cell marker (CD19, CD20, or CD23) and CD5 in peripheral blood or lymph node AND
Bone marrow with ≥ 30% mononuclear cells having the CLL/SLL phenotype.
Presence of at least ONE single accessible AND palpable lymph node in the cervical, supraclavicular, axillary, or inguinal regions. The size of the lymph nodes must be larger than 2x2 cm in the horizontal and perpendicular axes.
Intermediate or High risk, poor prognosis CLL/SLL

Indication for treatment as defined by the NCI Working Group Guidelines:

Massive (i.e. > 6 cm below the left costal margin) or progressive splenomegaly OR
Massive lymph nodes or nodal clusters (i.e. > 10 cm in longest diameter), or progressive lymphadenopathy OR
Grade 2 or 3 fatigue OR
Fever ≥ 100.5˚F or night sweats for greater than 2 weeks without documented infection OR
Presence of weight loss ≥ 10% over the preceding 6 months OR
Progressive lymphocytosis with an increase of ≥ 50% over a 2-month period or an anticipated doubling time of less than 6 months.
Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia and / or thrombocytopenia.
Autoimmune anemia and / or thrombocytopenia poorly responsive to corticosteroid therapy.
Males and females 18 years of age and older

Laboratory parameters as specified below:

Hematologic: Hemoglobin ≥ 10 g/dL (may be post-transfusion); platelet count ≥ 50 x103/mm3
Hepatic: Total Bilirubin < 2 X ULN, and ALT and AST < 2 x ULN
Renal: Creatinine ≤ 2 X ULN
ECOG Performance Status ≤ 2
Anticipated survival of at least 3 months
For men and women of child-producing potential, use of effective barrier contraceptive methods during the study and for one month following treatment.
Ability to understand the requirements of the study, provide written informed consent and authorization of use and disclosure of protected health information, and agree to abide by the study restrictions and return for the required assessments.
Negative test results for current/active infection with HIV-1, HIV-2, HTLV-1, HTLV-2, hepatitis A, B, C within 30 days of registration. (Antibody, antigen and nucleic acid tests acceptable, depending on institutional standards.).

Exclusion Criteria:

Pregnant or nursing women
Treatment with chemotherapy or monoclonal antibody within 28 days prior to entering the study.
Treatment with chemotherapy or monoclonal antibody during the time of participation in this trial.
Grade 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification
Severe or debilitating pulmonary disease (dyspnea at rest, significant shortness of breath, COPD)
Participation in any investigational drug study within 28 days prior to ISF35 administration. (Patient must have recovered from all acute effects of previously administered investigational agents)
History of malignancy other than CLL within five years of registration, except patients with adequately treated basal, squamous cell carcinoma or localized cervical cancer.
Active symptomatic fungal, bacterial and/or viral infection including active HIV or viral (A, B or C) hepatitis.
Any illness or condition that in the opinion of the Investigator may affect safety of treatment or evaluation of any the study's endpoints.