- Patients with recurrent solid tumors
- Patients with malignant melanoma
- Patients with hematological malignancies.
- Chronic myelogenous leukemia in chronic or accelerated phase, to include chronic
myelomonocytic leukemia (juvenile chronic myelogenous leukemia [JCML] or CMML).
- Acute lymphoblastic leukemia (ALL)
- First remission high-risk ALL (Ph+ with initial high white blood cell
[WBC]; t (4-11) in infants less than 1 year and CALLA negative)
- Second or subsequent remission ALL or isolated extramedullary disease on or
- Acute non-lymphocytic leukemia (ANLL)
- Patients with ANLL in first remission who have a matched sibling donor.
- ANLL in second remission, or patients who only achieve an initial partial
remission < 15% blasts, or early relapse.
- Myelodysplastic syndromes (MDS): refractory anemia (RA), refractory anemia with
excess blasts (RAEB), refractory anemia with excess blasts in transformation
(RAEB-T) and CMML/JCML.
- Selected immunodeficiencies:
- Wiskott-Aldrich syndrome.
- Severe combined immunodeficiency variants that require ablation.
- Hyper-IGM syndrome.
- Other immune deficiencies after approval from the medical director.
- Bone marrow failure syndromes (single or multiple hematopoietic lines)
- Venous access: A double lumen central vascular access device or its equivalent will
be required for all patients entered on the protocol.
- Informed consent: The donor and the patient and/or the patient's legally authorized
guardian must acknowledge in writing that consent to become a study subject has been
obtained in accordance with the institutional policy approved by the United States
(U.S.) Department of Health and Human Services.
- Patient organ function requirements:
- Adequate renal function: serum creatinine < 2 x normal, or creatinine clearance
calculated by Schwartz formula, of glomerular filtration rate (GFR) > 40
ml/min/1.73m2, or an equivalent GFR as determined by the institutional normal
- Adequate liver function: total bilirubin </= 2 x normal; and SGOT (AST) or SGPT
(ALT) </= 4 x normal.
- Adequate cardiac function: shortening fraction of > 24% by echocardiogram, or
ejection fraction of > 30% by radionuclide angiogram.
- Adequate pulmonary function: DLCO, FEV1 / FVC > 30% by pulmonary function test.
For children who are uncooperative for pulmonary function tests and have no
evidence of dyspnea at rest or exercise intolerance, pulse oximetry > 94% on
room air is considered acceptable.
- Performance status: Lansky >/= 60% for children </= 16 years of age; or
Karnofsky > 60% status for those > 16 years of age.
- Patients who are pregnant
- Inability to find a suitable donor for the patient
- Patient is HIV-positive
- Patient has active Hepatitis B
- Disease progression or relapse prior to HPC infusion
Minimum Eligible Age: N/A
Maximum Eligible Age: 21 Years
Eligible Gender: Both