Nonmyeloablative Peripheral Blood Stem Cell Transplant in Treating Patients with Hematologic Malignancies

Inclusion Criteria

• Molecular based human leukocyte antigen (HLA) typing will be performed for the HLA-A, -B, -Cw, DRB1 and –DQB1 loci to the resolution adequate to establish haplo identity; a minimum match of 5/10 is required; an unrelated donor search is not required for a patient to be eligible for this protocol if the clinical situation dictates an urgent transplant; clinical urgency is defined as 6-8 weeks from referral or low-likelihood of finding a matched, unrelated donor
• Subjects must meet one of the disease classifications listed below: * Acute leukemias (includes T lymphoblastic lymphoma); remission is defined as < 5% blasts with no morphological characteristics of acute leukemia (e.g., Auer Rods) in a bone marrow with > 20% cellularity, peripheral blood counts showing absolute neutrophil count (ANC) > 1000/ul, including patients in complete remission with incomplete platelet recovery (CRp) ** Acute lymphoblastic leukemia in high risk first complete remission (CR1) as defined by at least one of the following: *** Adverse cytogenetics such as t(9;22), t(1;19), t(4;11), mixed lineage leukemia (MLL) rearrangements *** White blood cell counts > 30,000/mcL *** Patients over 30 years of age *** Time to complete remission > 4 weeks *** Presence of extramedullary disease ** Acute myelogenous leukemia in high risk CR1 as defined by at least one of the following: *** Greater than 1 cycle of induction therapy required to achieve remission *** Preceding myelodysplastic syndrome (MDS) *** Presence of Fms-like tyrosine kinase 3 (Flt3) abnormalities *** French-American-British classification (FAB) M6 or M7 leukemia or *** Adverse cytogenetics for overall survival such as: **** Those associated with MDS **** Complex karyotype (>= 3 abnormalities) **** Any of the following: inv(3) or t(3;3), t(6;9), t(6;11), + 8 [alone or with other abnormalities except for t(8;21), t(9;11), inv(16) or t(16;16)], t(11;19)(q23;p13.1) ** Acute leukemias in 2nd or subsequent remission ** Biphenotypic/undifferentiated leukemias in 1st or subsequent complete remission (CR) ** High-risk MDS status-post cytotoxic chemotherapy ** Myelofibrosis * Burkitt’s lymphoma: second or subsequent CR * Lymphoma ** Chemotherapy-sensitive (complete or partial response) large cell, mantle cell or Hodgkin’s lymphomas that have failed at least 1 prior regimen of multi-agent chemotherapy and are ineligible for an autologous transplant or relapsed/progressed after autologous stem cell transplant ** Marginal zone B-cell lymphoma or follicular lymphoma that has progressed after at least two prior therapies (excluding single agent Rituxan) and are ineligible for an autologous transplant or relapsed/progressed after autologous stem cell transplant
• Left ventricular ejection fraction at rest must be >= 35%
• Bilirubin =< 2.5 mg/dL
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 5 x upper limit of normal (ULN)
• Alkaline phosphatase < 5 x ULN
• Serum creatinine within 0.5-1.4 mg/dL, or if serum creatinine outside 0.5-1.4 mg/dL, then renal function (creatinine clearance or glomerular filtration rate [GFR]) > 40 mL/min/1.73 m^2
• Forced expiratory volume in 1 second (FEV1) >= 40% predicted (corrected for hemoglobin); if unable to perform pulmonary function tests, the oxygen (O2) saturation > 92% on room air
• Forced vital capacity (FVC) >= 40% predicted (corrected for hemoglobin); if unable to perform pulmonary function tests, the O2 saturation > 92% on room air
• Diffusion capacity of the lung for carbon monoxide (DLCO) >= 40% predicted (corrected for hemoglobin); if unable to perform pulmonary function tests, the O2 saturation > 92% on room air
• Karnofsky/Lansky score >= 60%
• Patients who have received a prior allogeneic hematopoietic stem cell transplant (HSCT) and who have either rejected their grafts or who have become tolerant of their grafts with no active GVHD requiring immunosuppressive therapy
• DONOR: Donors must be HLA-haploidentical first-degree relatives of the patient; eligible donors include biological parents, siblings, or children, or half-siblings
• DONOR: Age >= 18 years
• DONOR: Weight >= 40 kg

Exclusion Criteria

• HLA-matched donor able to donate
• Pregnancy or breast-feeding
• Current uncontrolled bacterial, viral or fungal infection (currently taking medication with evidence of progression of clinical symptoms or radiologic findings)
• DONOR: Positive anti-donor HLA antibody