Nicotinamide Riboside Supplementation to Improve Engraftment after Donor Hematopoietic Stem Cell Transplant

Inclusion Criteria

• All disease indications for allogeneic hematopoietic cell transplantation except for myelofibrosis
• Age >= 18 years
• Subject must meet program eligibility criteria for myeloablative conditioning allogeneic (allo)HCT and plan to undergo myeloablative conditioning * Myeloablative conditioning regimen eligibility is determined by the subject’s transplant physician and bone marrow transplant (BMT) group. The current guideline defines that subjects are eligible if: subjects are =< 65 years old, Eastern Cooperative Oncology Group (ECOG) 0-1, no cardiac (ejection fraction [EF] > 45% or clearance by a Cleveland Clinic Foundation [CCF] cardiologist), pulmonary (forced expiratory volume in 1 second [FEV1] > 80% predicted on pulmonary function test [PFT] or clearance by a CCF pulmonologist), renal (creatinine [Cr] =< 2 or clearance by a CCF nephrologist), or liver comorbidities (aspartate aminotransferase [AST]/ alanine aminotransferase [ALT]/ alkaline phosphatase [ALKP] =< 3 x upper limit of normal [ULN] and bilirubin < 2 mg/dL or clearance by a CCF hepatologist), negative human immunodeficiency virus (HIV), and no other factors concerning for compromise in subject’s ability to tolerate intensive chemotherapy
• Human leukocyte antigen (HLA)-identical related donor or unrelated human donor source with bone marrow graft
• Subjects must provide a written informed consent

Exclusion Criteria

• History of allergy or intolerance to NR precursor compounds, including niacin or nicotinamide
• Pregnant or breastfeeding women are excluded from this study since allogeneic HCT is a strict contraindication
• Subjects with uncontrolled intercurrent illness or psychiatric illness/social situations that would limit compliance with study requirements