Very Low Dose Total Body Irradiation, Total Lymphoid Irradiation, and Anti-Thymocyte Globulin in Treating Patients Undergoing Donor Stem Cell Transplant

Inclusion Criteria

• Has a human leukocyte antigen (HLA)-matched or single allele-mismatched adult sibling donor or unrelated donor.
• Has a myeloid or lymphoid malignant disease that is treated with TLI and ATG reduced-intensity conditioning for allogeneic transplant (any of the following: acute myeloid leukemia [AML]; myelodysplastic syndrome [MDS]; myeloproliferative disease syndrome [MPD]); chronic lymphocytic leukemia (CLL); B or T-cell non-Hodgkin lymphoma (NHL); Hodgkin lymphoma (HL); or chronic myelomonocytic leukemia (CMML).
• Patients who due to age, pre-existing medical conditions, or, prior therapy are considered to be at high-risk for regimen-related toxicity associated with fully ablative transplant conditioning, and therefore reduced intensity conditioning is recommended.
• Ability to understand and the willingness to sign a written informed consent document. Patients must have signed informed consent to participate in the trial.

Exclusion Criteria

• Uncontrolled bacterial, viral or fungal infection defined as currently taking medication and progression of clinical symptoms.
• Progressive hemato-lymphoid malignancy despite conventional therapy.
• Chronic myelogenous leukemia (CML).
• Active central nervous system (CNS) involvement of the underlying malignancy.
• Human immunodeficiency virus (HIV)-positive.
• Pregnant or lactating.
• Prior malignancy (EXCEPTION: diagnosed > 5 years ago without evidence of disease, OR treated =< 5 years ago but have a greater than 50% chance of life expectancy of >= 5 years for that malignancy).
• Have a psychiatric disorder(s) or psychosocial circumstance(s) which in the opinion of the primary physician would place the patient at an unacceptable risk from transplant.
• Left ventricular ejection fraction (LVEF) < 30%, or uncontrolled cardiac failure.
• Diffusing capacity of lung for carbon monoxide (DLCO) < 40% predicted.
• Total bilirubin > 3 mg/dL.
• Serum glutamic oxaloacetic transaminase (SGOT) or serum glutamate pyruvate transaminase (SGPT) > 4 x upper limit of normal (ULN).
• Creatinine > 2 mg/dL and an estimated creatinine clearance < 40 mL/min.
• Poorly controlled hypertension despite multiple antihypertensive medications.
• Karnofsky performance status (KPS) < 60%.