Cyclophosphamide Plus T-Cell Transplantation for Patients With Hematologic Malignancies

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of 1 of the following:
• •* Myelodysplastic syndromes (MDS)
• •* International Prognostic Scoring System (IPSS) score ≥ intermediate-2
• •* Chronic myelomonocytic leukemia
• •* Acute myeloid leukemia arising from MDS
• •Must have failed or are ineligible for or intolerant to treatment with azacitidine
• •* Patients with normal marrow cytogenetics or an isolated 5q- abnormality must have failed or are ineligible for or intolerant to treatment with lenalidomide
• •* Patients who are HLA-DR15-positive must have failed or are ineligible for pharmacologic immunosuppression (e.g., anti-thymocyte globulin, cyclosporine, steroids)
• •No presence of cytotoxic antibodies against donor lymphocytes
• •No HLA-identical donor available OR ineligible for HLA-identical allogeneic bone marrow transplantation
• •HLA partially mismatched (haploidentical) related donor available
• •* First-degree related donor, including half-siblings or first cousins
• •* Inherited recombinant haplotype from parents allowed if donor shares ≥ 1 HLA antigen at each of the HLA-A, -B, and DR loci
• •PATIENT CHARACTERISTICS:
• •ECOG performance status (PS) 0-1 OR Karnofsky PS 80-100%
• •Bilirubin \< 3.0 mg/dL
• •AST and ALT ≤ 4 times upper limit of normal
• •Creatinine \< 3.0 mg/dL
• •LVEF \> 35%
• •PRIOR CONCURRENT THERAPY:
• •See Disease Characteristics
• •Recovered from prior therapy
• •No prior transfusions from donor
• •At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) or radiotherapy
• •No other concurrent investigational drugs