Conventional and Regulatory T Cells in Treating Patients with Advanced Hematologic Malignancies Undergoing T Cell-Depleted Donor Stem Cell Transplant

Inclusion Criteria

• Patients with the following diseases that are histopathologically confirmed are eligible * Acute leukemia, primary refractory or beyond CR1, or minimal residual disease (MRD) positivity * High risk acute myeloid leukemia in CR1 with any of the following features: ** Complex karyotype (>= 3 clonal chromosomal abnormalities) ** Any of the following high risk chromosomal abnormalities: *** Monosomal karyotype (-5; 5q-; -7; 7q-) *** t(11q23); t(9;11); inv(3); t(3;3); t(6;9); t(9;22) *** Normal karyotype with FLT3 ITD mutation ** Other high risk features as determined by molecular studies, or clinical presentation as assessed by the treating physician * Chronic myelogenous leukemia (accelerated, blast or second chronic phase or first chronic phase that and has not achieved a molecular remission after three or greater therapies) * Myelodysplastic syndromes * Myeloproliferative syndromes * Non Hodgkin lymphoma with poor risk features not suitable for autologous HCT
• Left ventricular ejection fraction (LVEF) >= 45%
• Diffusing capacity of the lungs for carbon monoxide (DLCO) >= 50%
• Calculated creatinine clearance >= 50 mL/min or creatinine < 2.0 mg/dL
• Serum glutamate pyruvate transaminase (SGPT) and serum glutamic oxaloacetic transaminase (SGOT) =< 2.5 x upper limit of normal (ULN), unless elevated secondary to disease
• Total bilirubin =< 2 x ULN (patients with Gilbert syndrome may be included at the discretion of the principal investigator [PI] or where hemolysis has been excluded)
• Negative serum or urine beta human chorionic gonadotropin (HCG) test in females of childbearing potential
• Availability of a 6/6 or 5/6 human leukocyte antigen (HLA) matched donor (related or unrelated) defined by Class I (HLA–A and B) serologic typing (or higher resolution) and Class II (HLA DRB1) molecular typing. If the donor is a 5/6 HLA match, the mismatch must be a permissive allelic mismatch as assessed by an independent HLA and transplantation expert
• Karnofsky performance status >= 70%
• DONOR: Age >= 13 years old (yo) and =< 75 years
• DONOR: Karnofsky performance status of >= 70% defined by institutional standards or cleared by the National Marrow Donor Program (NMDP) for NMDP donors
• DONOR: Seronegative for human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) polymerase chain reaction (PCR), HIV 1 and HIV 2 antibody (ab), human T-cell lymphotropic virus type (HTLV)-1 and HTLV-2 ab; PCR positive (+) or surface antigen (sAg) hepatitis B; or PCR+ or sAg for hepatitis C; negative for the Treponema palladum antibody syphillis screen; and negative for HIV-1 and hepatitis C by nucleic acid testing (NAT) within 40 days of donor apheresis procedures; in the case that Treponema (T) palladum antibody tests are positive, donors must: * Be evaluated and show no evidence of syphilis infection of any stage by physical exam and history * Have completed effective antibiotic therapy to treat syphilis * Have a documented negative non treponemal test (such as rapid plasma reagin [RPR]) or in the case of a positive non treponemal test must be evaluated by an infectious disease expert to evaluate for alternative causes of test positivity and confirm no evidence of active syphilitic disease
• DONOR: Must be a related or unrelated, 5/6 or 6/6 HLA match to recipient; if 5/6 HLA matched, must be with permissive allelic HLA mismatch as assessed by an independent HLA and transplantation expert
• DONOR: Female donors of child-bearing potential must have a negative serum or urine beta-human chorionic gonadotrophin (HCG) test
• DONOR: Capable of undergoing leukapheresis, have adequate venous access, and be willing to undergo insertion of a central catheter should leukapheresis via peripheral vein be inadequate
• DONOR: The donor or legal guardian greater than 18 years of age, capable of signing an Institutional Review Board (IRB)-approved consent form
• DONOR: Agreeable to 2nd donation of peripheral blood stem cell transplantation (PBPC) (or bone marrow harvest) in the event of graft failure
• DONOR: Meet criteria for donation as specified by standard NMDP guidelines for NMDP unrelated donors

Exclusion Criteria

• Seropositive for any of the following: human immunodeficiency virus (HIV) antibodies; hepatitis B surface antigen (sAg); hepatitis C antibodies
• Prior myeloablative therapy or hematopoietic cell transplant
• Candidate for autologous transplant
• HIV positive
• Active uncontrolled bacterial, viral or fungal infection, defined as currently taking antimicrobial therapy and progression of clinical symptoms
• Uncontrolled central nervous system (CNS) disease involvement
• Pregnant or a lactating female
• Positive serum or urine beta HCG test in females of childbearing potential
• Psychosocial circumstances that preclude the patient being able to go through transplant or participate responsibly in follow up care
• DONOR: Evidence of active infection
• DONOR: HIV-positive
• DONOR: Medical, physical, or psychological reason that would place the donor at increased risk for complications from growth factor or leukapheresis
• DONOR: Lactating female