Inclusion Criteria:
- Age 0 (newborn) - 30 years
- Patient must have a malignant or non-malignant disease that can benefit from
alternative stem cell transplantation according to standard practice guidelines.
- Patients with lymphoma or acute leukemia (except acute myeloid leukemia, AML) must be
in remission at the time of transplant.
- Patients must lack a healthy human leukocyte antigen (HLA)-identical related donor.
- Recipient or authorized guardian must sign informed consent for this study.
- If recipient is female and of child-bearing age, negative pregnancy test.
- Patient must have a healthy, willing mismatched related or an unrelated donor who is:
- Able to receive granulocyte colony-stimulating factor (G-CSF) and undergo
apheresis either through placement of catheters in antecubital veins or a
temporary central venous catheter,
- For Related donor: sibling, half-sibling, parent, cousin, aunt, uncle or
grandparent will all be considered eligible.
- For Related donor: HLA antigen genotypic match 4/8 and 7/8
(haplocompatible).
- For unrelated donor: 6/8 or 7/8 HLA antigen match (if two mismatches, they must
be at different loci).
- Complete medical history, physical and screening for infectious diseases that
are acceptable for donation.
- If donor is female and of child-bearing age, negative pregnancy test.
- Absence of anti-HLA antibodies in recipient directed against donor antigens.
- Donor must be willing to sign informed consent for this study. If donor is < 18
years of age, donor must be willing to give assent and parents willing to sign
informed consent. For unrelated donors: The National Marrow Donor Program (NMDP)
will obtain informed consent for donor's apheresis product to be used in this
study.
- Age 5 years
Exclusion Criteria:
- Patient with an anticipated life expectancy of < 1 month
- Active infectious hepatitis or cytomegalovirus (CMV) disease (organ involvement)
- Human immunodeficiency virus (HIV) or Human T-lymphotropic virus (HTLV-I/II)
infection
- Cardiac ejection fraction < 45%; can be lower if patient is not in clinical cardiac
failure and a reduced intensity conditioning regimen is used.
- Creatinine clearance <60 ml/min/1.72 m2; can be lower if a reduced intensity
conditioning regimen is used.
- Pulmonary diffusion capacity (corrected for hemoglobin), forced expiratory volume in
one second (FEV1), or forced vital capacity (FVC) <60% of predicted or oxygen
saturation (O2 sat) > 94% on room air if unable to perform pulmonary function tests
(PFTs); can be lower if a reduced intensity conditioning regimen is used.
- Serum alanine aminotransferase (ALT) > 5 x upper limit of normal (can be up to 10x
upper limit of normal if a reduced intensity conditioning regimen is used) or
bilirubin > 2.
- Performance score (Lansky/Karnofsky) < 50
- Any condition that compromises compliance with the procedures of this protocol, as
judged by the principal investigator.
Minimum Eligible Age: N/A
Maximum Eligible Age: 30 Years
Eligible Gender: Both
T cell depleted
Matched unrelated donors
Haplocompatible donors
Graft vs Host Disease
Hemoglobinopathies
Leukemia
Leukemia, Lymphoid
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia, Myeloid, Acute
Leukemia, Myeloid
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Lymphoma
Myelodysplastic Syndromes
Preleukemia
Osteopetrosis
Pancytopenia
Immune System Diseases
Hematologic Diseases
Genetic Diseases, Inborn
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Myeloproliferative Disorders
Bone Marrow Diseases
Precancerous Conditions
Osteosclerosis
Osteochondrodysplasias
Bone Diseases, Developmental
Bone Diseases
Musculoskeletal Diseases
Severe acquired and congenital cytopenias
White and red blood cell abnormalities