Pediatric Study of GVHD Ppx w/o Calcineurin Inhibitors After Day60 Post First Allo HSCT for Hematological Malignancies.

Inclusion Criteria

• •Diagnosis:
• •Patients with high risk acute lymphoblastic leukemia in first remission. Examples include, but are not limited to, patients with certain leukemic cell cytogenetic findings (e.g. t(9;22) or t(4;11)); delayed response to induction chemotherapy; re-emergence of leukemic blasts by MRD (at any level) in patients previously MRD negative; persistently detectable MRD at lower levels; early T-cell precursor (ETP) ALL.
• •Patients with acute lymphoblastic leukemia beyond first remission.
• •Patients with Hodgkin's disease beyond first remission or with refractory disease.
• •Patients with chronic myelogenous leukemia.
• •Patients with primary or secondary myelodysplastic syndrome.
• •Patients with Non-Hodgkin's lymphoma beyond first remission or with refractory disease.
• •Patients with de novo acute myeloid leukemia in or beyond first remission or with relapsed or refractory disease, or myeloid sarcoma (extra-medullary AML).
• •Patients with secondary acute myeloid leukemia.
• •NK cell lymphoblastic leukemia in any CR.
• •Biphenotypic, bilineage, or undifferentiated leukemia.
• •Juvenile Myelomonocytic Leukemia (JMML)
• •All patients with prior evidence of CNS leukemia must be treated and be in CNS CR.
• •Patients must have a related or unrelated donor matched at 12 of 12 HLA alleles.
• •Patient must have a Karnofsky/Lansky score of 70 or higher.
• •Patients must be 12 years of age or older.
• •Patients must have a shortening fraction \>26% or left ventricular ejection fraction \>40%.
• •Patients must have bilirubin less than or equal to 2.5 mg/dL and alanine aminotransferase (ALT) less than or equal to 5 times the upper limit of normal.
• •Patients must have creatinine clearance, or a glomerular filtration rate (GFR), greater than 70 mL/min/1.73m2.
• •Patients must be free of severe infection that upon determination of principal investigator precludes BMT.
• •Patients must have FVC \>50% predicted OR, if unable to perform pulmonary function testing, must maintain pulse oximetry oxygen saturation \>92% on room air.
• •Female patients of childbearing age must have a negative pregnancy test.