Cyclophosphamide in Preventing GVHD in Patients with Abnormal Kidney Function Undergoing Donor Stem Cell Transplant

Inclusion Criteria

• Patients who are deemed eligible for transplant by their treating physician
• Acute myeloid leukemia (AML) in >= first (1st) remission - excluding those in 1st remission with ‘good risk’ cytogenetic features (i.e. t(8;21), t(15;17), inv 16)
• Secondary AML
• Acute lymphoblastic leukemia (ALL)/lymphocytic leukemia (LL) in 1st remission with clinical or molecular features indicating a high risk for relapse; or ALL > second (2nd) remission
• Chronic myeloid leukemia (CML) failing to respond to, progressing on or not tolerating appropriate tyrosine kinase inhibitor (TKI) therapy in first chronic phase of disease; CML in accelerated phase, second chronic phase, or in complete remission (CR) after accelerated phase or blast crisis
• Non-Hodgkin's lymphoma with chemoresponsive disease in any of the following categories: * High grade lymphomas who have failed to achieve a first CR or have relapsed following a 1st remission who are not candidates for autologous transplants or transplants requiring the use of calcineurin inhibitors * Any NHL with therapy responsive disease which is considered not curable outside the transplant setting and not eligible/appropriate for autologous transplant or a higher priority protocol
• Myelodysplastic syndrome (MDS): refractory anemia (RA)/refractory cytopenia with multilineage dysplasia (RCMD) with high risk cytogenetic features or transfusion dependence, refractory anemia with excess blasts (RAEB)-1 and RAEB-2 and AML evolved from MDS, who are not eligible for a higher priority protocol
• Chronic myelomonocytic leukemia (CMML)-1 and CMML-2, advanced polycythemia vera, and myelofibrosis * Patients must have a healthy human leukocyte antigen (HLA) compatible (8/8 molecularly matched related, or unrelated) donor willing to undergo bone marrow (BM) harvesting or peripheral blood stem cell (PBSC) apheresis after filgrastim (G-CSF) administration; BM will be the preferred graft source * Patients diagnosed with any form of acute leukemia must have received induction and at least one course of consolidation chemotherapy pretransplant
• Patients must have a Karnofsky performance status >= 70%
• Patients will have an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m^2
• Cardiac: asymptomatic or if symptomatic then left ventricular ejection fraction (LVEF) at rest must be > 50% and must improve with exercise
• Alanine aminotransferase (ALT) < 3 x upper limit or normal (ULN)
• Total serum bilirubin < 1.5 x ULN, unless there is congenital benign hyperbilirubinemia
• eGFR > 30 ml/min/1.73 m^2
• Pulmonary: asymptomatic or if symptomatic, diffusing capacity of the lungs for carbon monoxide (DLCO) > 50% of predicted (corrected for hemoglobin)
• Each patient must be willing to participate as a research subject and must sign an informed consent form
• Patient must have a fully matched related or unrelated donor willing to donate stem cells

Exclusion Criteria

• Major surgery or irradiation within two weeks
• Active central nervous system (CNS) or extramedullary malignant disease
• Active and uncontrolled infection at time of transplantation including active infection with Aspergillus or other mold, or human immunodeficiency virus (HIV) infection
• Pregnant or lactating women
• Male and female patients of child-bearing potential unwilling to use effective means of contraception
• HIV or human T-lymphotropic virus (HTLV) I/II positive, hepatitis C or chronic active hepatitis B
• Patients who have had a previous malignancy unless they are deemed by their treating physicians to be at low risk for recurrence
• Patient or guardian unable to give informed consent or unable to comply with the treatment protocol including appropriate supportive care, follow-up and research tests