Intra-Osseous Co-Transplant of UCB and hMSC

PRIMARY OBJECTIVES: I. To estimate the feasibility of combining intra-osseous umbilical cord blood (UCB) hematopoietic stem cells and human mesenchymal stromal cells (hMSC) following reduced intensity conditioning (RIC). SECONDARY OBJECTIVES: I. To estimate the time to engraftment of intra-osseous (IO) UCB transplant combined with hMSC following RIC. II. To estimate the safety profile of IO UBC transplant combined with hMSC. OUTLINE: REDUCED INTENSITY CONDITIONING: Patients receive cyclophosphamide intravenously (IV) over 2 hours on day -6 and fludarabine phosphate IV on days -6 to -2 and undergo total body irradiation (TBI) on day -1. GRAFT-VERSUS-HOST DISEASE (GVHD) PROPHYLAXIS: Patients receive cyclosporine orally (PO) or IV over 2 hours every 12 hours on beginning on days -5 to 100 with taper beginning on day 100 and mycophenolate mofetil IV or PO twice daily (BID) on days -5 to 100. TRANSPLANT: Patients undergo intra-osseous UCB and hMSC co-transplant on day 0. After completion of study treatment, patients are followed up at days 28 and 100, and then at 6, 9, and 12 months.