Tacrolimus and Thymoglobulin, as GvHD Prophylaxis in Patients Undergoing Related Donor HCT

Inclusion Criteria:

• Suitable related donor as determined by the treating physician
• High resolution molecular HLA typing is mandatory for HLA Class I and II
• Diagnosis of hematological malignancy
• Patients with one of the following hematologic malignancies, and felt to be transplant candidates by their treating physician are eligible to enroll on this protocol:
• Non-Hodgkin lymphoma, any complete remission (CR)/partial remission (PR)
• Hodgkin disease, any CR/PR/stable disease (SD)
• Acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) any CR; for non-CR AML or ALL, bone marrow blast < 20% within 4 weeks of transplant and peripheral blood (PB) absolute blast count < 500/μl on the day of initiation of conditioning
• Myelodysplastic syndrome (MDS), treated or untreated
• Chronic myelogenous leukemia (CML) in chronic phase or accelerated phase
• Chronic myelomonocytic leukemia (CMML)
• Multiple myeloma, any CR/PR/SD
• Chronic lymphocytic leukemia (CLL) any CR/PR
• Myelofibrosis and other myeloproliferative disorders; bone marrow blasts less than 20 percent within four weeks of transplant and peripheral blood absolute blast counts less than 500 per microliter on the day of initiation of conditioning
• Age >= 18 and able to cooperate with oral medication intake
• Filgrastim (G-CSF) mobilized Peripheral blood stem cells
• Agrees to participate, and informed consent signed
• Karnofsky performance status (KPS) >= 60, Eastern Cooperative Oncology Group (ECOG) performance status =< 2
• Creatinine clearance > 60 mL/min
• Ejection fraction > 50%
• Serum bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) less than 3 X upper limit of normal
• Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) or diffusion capacity of carbon monoxide (DLCO) > 50% predicted

Exclusion Criteria:

• Bone marrow or Ex vivo engineered or processed graft (cluster of differentiation [CD]34+ enrichment, T-cell depletion, etc)
• Patients with documented uncontrolled central nervous system (CNS) disease
• Active donor or recipient serology positive for human immunodeficiency virus (HIV)
• Known contraindication to administration of Tacrolimus or Thymoglobulin
• Active Hepatitis B or C
• Patients with coronary heart disease (recent myocardial infarctions, angina, cardiac stent, or bypass surgery in the last 6 months) need to be cleared with a stress echocardiogram or nuclear myocardial perfusion stress test, and cardiology consult; all other cardiac history will be at the discretion of the Principal Investigator
• Oxygen usage at the time of enrollment
• Patients with clinical ascites
• Women who are pregnant or nursing