Giving Chemotherapy and rATG for a Shortened Amount of Time before a Donor Stem Cell Transplantation for the Treatment of Patients with Blood Cancers

Inclusion Criteria

• Patients aged >= 18 years old
• Patients with any of the following hematologic malignancies for which allogeneic (allo)-hematopoietic cell transplantation (HCT) is indicated, including: * Acute myeloid leukemia (AML) with intermediate or high-risk features in first complete remission (CR1) * Relapsed AML in >= second complete remission (CR2) * Acute leukemias of ambiguous lineage in >= CR1 * Acute lymphoid leukemia (ALL) in CR1 with clinical, flow cytometric, or molecular features indicating a high risk for relapse, or ALL in >= CR2 * Chronic myelogenous leukemia (CML) meeting one of the following criteria: ** Failed response to or intolerant to BCR-ABL tyrosine kinase inhibitors (TKIs) ** CML with BCR-ABL mutation consistent with poor response to TKIs (e.g., T315I mutation) ** CML in accelerated phase or blast crisis with < 10% blasts after therapy, or in second chronic phase * Myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN), or MDS/MPN overlap syndromes with least one of the following: ** Revised International Prognostic Scoring System risk score of intermediate or higher at the time of transplant evaluation ** Life-threatening cytopenias ** Karyotype or genomic changes that indicate high risk for progression to acute myelogenous leukemia, including abnormalities of chromosome 7 or 3, mutations of TP53, or complex or monosomal karyotype ** Therapy related disease or disease evolving from other malignant processes * Chronic myelomonocytic leukemia (CMML-1 or CMML-2) * Severe aplastic anemia * Relapsed Hodgkin lymphoma meeting both of the following criteria: ** Responding to therapy prior to enrollment ** Relapse after autologous HCT or are ineligible for autologous HCT * Relapsed non-Hodgkin lymphoma meeting both of the following criteria: ** Responding to therapy prior to enrollment ** Relapse after prior autologous HCT or are ineligible for autologous HCT * High-risk multiple myeloma following autologous HCT or relapsed multiple myeloma following autologous HCT with chemosensitive disease
• Serum bilirubin =< 2 mg/dL, unless benign congenital hyperbilirubinemia. Patients with hyperbilirubinemia related to paroxysmal nocturnal hemoglobinuria or other hemolytic disorders are eligible with principal investigator (PI) approval
• Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase < 3 times the upper limit of normal unless thought to be disease-related
• Creatinine clearance >= 50 ml/min (calculated by Cockcroft Gault)
• Left ventricular ejection fraction (LVEF) >= 45% by multigated acquisition scan (MUGA) or resting echocardiogram
• Pulmonary function (forced expiratory volume in one second [FEV1] and corrected diffusing capacity for carbon monoxide [DLCO]) >= 50% predicted
• Adequate performance status of Eastern Cooperative Oncology Group (ECOG) =< 2
• Each patient must be willing to participate as a research subject and must sign an informed consent form
• DONOR: Must be a 10/10 human leukocyte antigen (HLA) genotypically matched related or unrelated donor at A, B, C, DRB1, and DQB1 loci, as tested by deoxyribonucleic acid (DNA) analysis
• DONOR: Able to provide informed consent for the donation process per institutional standards
• DONOR: Meet standard criteria for donor collection as defined by the National Marrow Donor Program Guidelines

Exclusion Criteria

• Patients with active extramedullary disease
• Patients with active central nervous system malignancy
• Active and/or uncontrolled infection at the time of allo-HCT
• Patients who have undergone previous allo-HCT
• Patients who have undergone previous autologous HCT within the last 6 months, with the exclusion of high-risk multiple myeloma patients
• Patient seropositivity for human immunodeficiency virus (HIV) I/II and/or human T-cell leukemia virus (HTLV) I/II
• Females who are pregnant or breastfeeding
• Patients unwilling to use contraception during the study period
• Patient or guardian unable to give informed consent or unable to comply with the treatment protocol