Chemotherapy, Total Body Irradiation, and Post-Transplant Cyclophosphamide in Reducing Rates of Graft Versus Host Disease in Patients With Hematologic Malignancies Undergoing Donor Stem Cell Transplant

Inclusion Criteria

• •The patient must have a diagnosis of one of the following (one must be yes):
• •* Acute myeloid leukemia (AML)
• •* Acute lymphoblastic leukemia (ALL)
• •* Chronic lymphoblastic leukemia (CLL)
• •* Chronic myelogenous leukemia (CML) (chronic phase intolerant or unresponsive to tyrosine kinase inhibitors, accelerated phase, history of blast crisis)
• •* Myelodysplastic syndrome (MDS)
• •* Non-Hodgkin lymphoma (NHL)
• •* Hodgkin lymphoma (HL) (received and failed frontline therapy or failed autologous transplantation or inability to collect enough peripheral blood stem cells \[PBSC\] for autologous hematopoietic cell transplant \[auto-HCT\])
• •* Multiple myeloma (MM)
• •* Severe aplastic anemia
• •Histocompatible donor identified:
• •* Related donor matched 5/6 or better (A, B, DRB1)
• •* Unrelated donor matched 7/8 or better (A, B, C and DRB1)
• •Patients with severe aplastic anemia do not have disease requirements; however, if the patient has a mismatched donor, the patient must have had prior therapy with ATG.
• •The following are eligible for study inclusion:
• •Patients with MDS/MPN only require \<5% myeloblast on bone marrow evaluation.
• •Patients with AML, ALL or CLL may be in CRi, patients with MM may be in VGPR
• •Patients with NHL/HL must be in CR
• •* Have a Karnofsky performance status score of \> 50%
• •* Diffusing capacity of the lung for carbon monoxide (DLCO) \> 40% predicted, corrected for hemoglobin and/or alveolar ventilation
• •* Left ventricular ejection fraction \> 40%
• •* Bilirubin =\< 3 x upper limit of normal
• •* Liver alkaline phosphatase =\< 3 x upper limit of normal
• •* Serum glutamic-oxaloacetic transaminase (SGOT) or serum glutamate pyruvate transaminase (SGPT) =\< 3 x upper limit of normal
• •* Calculated creatinine clearance \> 40 cc/min by the modified Cockroft-Gault formula
• •* Patient must be cleared pre-transplant by Radiation Oncology to be able to receive 400 cGy
• •* Participants of child-bearing potential must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately
• •* Patients who have failed a prior autologous or allogeneic transplant are eligible; however, at least 6 months must have elapsed between the start of this reduced intensity conditioning regimen and the last transplant if patient had a prior autologous or myeloablative allogeneic bone marrow transplant (BMT)
• •* At least 2 weeks since prior radiation treatment and/or surgery. Appropriate washout of prior chemotherapy per BMT standard of care. If medication is not on the list, go by physician discretion
• •* Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure