Tacrolimus and Mycophenolate Mofetil as Post-Grafting Immunosuppression

OBJECTIVES Major Objectives A. To determine whether stable allogeneic hematopoietic engraftment can be safely established in patients receiving a non-myeloablative allogeneic SCT from an HLA-Identical or non-identical family donor or unrelated donors, with fludarabine and low-dose TBI, with immunosuppression utilizing tacrolimus and MMF. B. To evaluate the incidence of grade II-IV GVHD associated with this treatment. C. To evaluate the engraftment when donors who are not HLA-identical family members are utilized for allogeneic stem cell transplantation. D. To evaluate the incidence of GVHD using three times per day MMF after unrelated donor stem cell transplants or two times per day MMF after family donor stem cell transplant. Minor Objectives A. To evaluate the incidence of chronic GVHD utilizing Tac/MMF with peripheral blood stem cells from matched or mis-matched allogeneic donors. B. To evaluate disease responses and survival after Flu/TBI allogeneic SCT.