Donor Transplant, Total Lymphoid Irradiation, and Antithymocyte Globulin in Treating Patients with Cutaneous T-cell Lymphoma

Inclusion Criteria

• Stage IIB-IV mycosis fungoides or Sezary syndrome, who have failed at least 1 standard systemic therapy or are not candidates for standard therapy
• Pathology reviewed and the diagnosis confirmed at Stanford University Medical Center
• Karnofsky performance status >= 70%
• Corrected diffusion capacity of the lung for carbon monoxide (DLCO) >= 40%
• Left ventricle ejection fraction (LVEF) >= 30%
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) must be =< 3 X normal * If AST and ALT are > 3 =< 5 x upper limit of normal (ULN), patient may be eligible if: ** Liver biopsy performed within 60 days of hematopoietic cell transplantation (HCT) excludes active cirrhosis grade greater than 2/4 and bridging fibrosis ** No clinically evident ascites ** Patient with hepatitis B or C are excluded if AST or ALT > 3 x upper limit (UL)
• Total bilirubin =< 2 mg/dL unless hemolysis or Gilbert’s disease
• Estimated creatinine clearance >= 50 ml/min
• Have a related or unrelated human lymphocyte antigen (HLA) -identical donor or one antigen/allele mismatched in HLA-A, B, C or DRB1
• Signed informed consent
• Patients with prior malignancies diagnosed > 5 years ago without evidence of disease are eligible
• Patients with a prior malignancy treated < 5 years ago but have a life expectancy of > 5 years for that malignancy are eligible
• DONOR: Age >= 17
• DONOR: Human immunodeficiency virus (HIV) seronegative
• DONOR: No contraindication to the administration of filgrastim (G-CSF)
• DONOR: Willing to have a central venous catheter placed for apheresis if peripheral veins are inadequate

Exclusion Criteria

• Uncontrolled active infection
• Uncontrolled congestive heart failure or angina
• Pregnancy or nursing patients will be excluded from the study
• Those who are HIV-positive will be excluded from the study
• DONOR: Serious medical or psychological illness
• DONOR: Pregnant or lactating women are not eligible
• DONOR: Prior malignancies within the last 5 years except for non-melanoma skin cancers