Tipifarnib in Treating Patients With Myelofibrosis and Myeloid Metaplasia

Inclusion Criteria:

Histopathologic confirmation (on bone marrow trephine and aspirate) of myelofibrosis with myeloid metaplasia by a pathologist/hematologist at the registering institution; included in the diagnosis of MMM are AMM (agnogenic myeloid metaplasia), PPMM (post-polycythemic myeloid metaplasia), and PTMM (post-thrombocythemic myeloid metaplasia); the bone marrow should show the presence of reticulin fibrosis, and the peripheral blood smear should show the presence of leukoerythroblastosis and dacrocytosis
Bone marrow showing no evidence of other conditions associated with myelofibrosis, such as metastatic carcinoma, lymphoma, myelodysplasia, hairy cell leukemia, mast cell disease, acute leukemia (including M7 type), or acute myelofibrosis
Bone marrow chromosome analysis or peripheral blood or bone marrow Fluorescent In Situ Hybridization (FISH) showing absence of chromosomal translocation t(9:22); prior demonstration is sufficient for enrollment purposes

At least one of the following:

Anemia evidenced by hemoglobin < 10 g/dL
Palpable hepato-splenomegaly
ANC ≥ 750/mm^3
PLT ≥ 100,000/mm^3
Total bilirubin (direct if total elevated) ≤ UNL
Alkaline phosphatase =< 3 x UNL (unless felt to be secondary to disease)
AST ≤ 2.5 x UNL
Creatinine =< 1.5 x UNL
Ability to understand and the willingness to sign a written informed consent document
Willingness to follow the schedule for returning to the registering P2C institution (monthly) while receiving protocol treatment
ECOG performance status 0, 1, or 2

Exclusion Criteria:

Any of the following as this regimen may be harmful to a developing fetus or nursing child:

Pregnant women
Breastfeeding women
Men or women of childbearing potential or their sexual partners who are unwilling to employ adequate contraception (condoms, diaphragm, birth control pills, injections, intrauterine device [IUD], surgical sterilization, subcutaneous implants, or abstinence, etc.)
NOTE: The effects of the agent(s) on the developing human fetus at the recommended therapeutic dose are unknown
Use of cytotoxic chemotherapy or other myelosuppressive agents within =< 2 weeks prior to study entry

Uncontrolled intercurrent illness or any co-morbid condition that would limit compliance with study requirements or with which the use of R115777 is felt to be potentially harmful; such conditions include, but are not limited to:

Ongoing or active infection
Symptomatic congestive heart failure
Unstable angina pectoris
Cardiac arrhythmia, or
Psychiatric illness/social situations
Other concurrent therapy directed at the disease (including Thalidomide) or use of erythropoietin while enrolled in this study; such agents must be discontinued at the time of or prior to study entry
Known quinolone sensitivity