Mismatched Family Member Donor Transplantation for Children and Young Adults With High Risk Hematological Malignancies

Inclusion Criteria

• •Patients less than or equal to 21 years of age; may be greater than 21 years old if a current St. Jude patient or previously treated St. Jude patient within 3 years of completion of prior treatment.
• •Must have one of the following diagnosis:
• •* ALL high risk in second remission. Examples include relapse on therapy, first remission duration of less than or equal to 30 months, or relapse within 12 months of completing therapy.
• •* ALL in third or subsequent remission.
• •* ALL high risk in first remission. Examples include: induction failure, minimal residual disease greater than or equal to 1% marrow blasts by morphology after induction, persistent or recurrent cytogenetic or molecular evidence of disease during therapy requiring additional therapy after induction to achieve remission.
• •* High-risk AML in first remission. Examples include monosomy 7, M6, M7, t(6;9), FLT3-ITD, or patients who have greater than or equal to 25% blasts by morphology after induction or who do not achieve CR after 2 courses of therapy (includes myeloid sarcoma).
• •* Relapsed or persistent AML (less than or equal to 25% blasts in marrow by morphology).
• •* AML in second or subsequent morphologic remission (includes myeloid sarcoma).
• •* CML in first chronic phase with detectable molecular or cytogenetic evidence of disease despite medical therapy; or CML with a history of accelerated or blast crisis, now in chronic phase; or unable to tolerate tyrosine kinase inhibitor therapy.
• •* Juvenile myelomonocytic leukemia (JMML).
• •* Myelodysplastic syndrome (MDS).
• •* Therapy related (secondary) AML, ALL, or MDS.
• •* Hodgkin lymphoma after failure of prior autologous HSCT or unsuitable for autologous HSCT.
• •* Non-Hodgkin lymphoma (NHL) in second complete remission (CR2) or subsequent.
• •Has not received a prior allogeneic hematopoietic stem cell transplant.
• •Does not have a suitable HLA-matched sibling donor available for stem cell donation.
• •Does not have a suitable cord blood product or volunteer matched unrelated donor (MUD) available in the necessary time for stem cell donation.
• •Has a suitable HLA partially matched family member available for stem cell donation.
• •Cardiac shortening fraction greater than or equal to 25%.
• •Creatinine clearance or glomerular filtration rate (GFR) greater than or equal to 40 ml/min/1.73 m\^2.
• •Forced vital capacity (FVC) greater than or equal to 40% of predicted value or a pulse oximetry value of greater than or equal to 92% on room air.
• •Direct bilirubin less than or equal to 3 mg/dl.
• •Age-dependent performance score of greater than or equal to 50.
• •Serum glutamic pyruvic transaminase (SGPT) less than 3 times the upper limit of normal for age.
• •Karnofsky or Lansky (age-dependent) performance score of greater than or equal to 50.
• •No known allergy to murine products or human anti-mouse antibody (HAMA) results within normal limits.
• •Not pregnant (confirmed by negative serum or urine pregnancy test within 14 days prior to enrollment).
• •Not breast feeding.
• •Partially HLA matched family member.
• •At least 18 years of age.
• •Human immunodeficiency virus (HIV) negative.
• •Not pregnant (confirmed by negative serum or urine pregnancy test within 7 days prior to enrollment).
• •Not breast feeding.
• •Has experienced one of the following disorders post-transplant:
• •graft failure
• •graft rejection
• •delayed hematopoietic and/or immune reconstitution.
• •Exclusion: NA