Bone Marrow Transplantation With Specially Treated Bone Marrow in Treating Patients With Hematologic Cancer That Have Not Responded to Previous Therapy

Inclusion Criteria:

• Age ≤40 years.

• Diagnoses-patients with the following hematologic malignancies and bone marrow failure syndromes:

  • Acute myelogenous leukemia-induction failure, relapse, second or greater complete remission (CR)
  • Acute lymphocytic leukemia-induction failure, relapse, second or greater CR, first CR with t(9;22), t(8;14), or t(4;11)
  • Non-Hodgkin's lymphoma (intermediate or high grade) which has failed to achieve CR with at least two induction regimens, relapse, second or greater CR
  • Multiple myeloma with poor prognostic features (elevated 0-2 microglobulin or high labeling index)
  • Hodgkin's disease in relapse or which fails to achieve CR after two chemotherapy regimens
  • Congenital or acquired bone marrow failure - poorly responsive to or intolerant of current therapy
  • Myelodysplastic syndrome of all subtypes except refractory anemia (RA)
• Patient has a haploidentical family member that meets medical criteria for donation.

• Eligibility for other transplant types:

  • Patient considered likely to have clinical deterioration and rapid disease progression during an unrelated donor search, or
  • Patient who has already had an unproductive donor search or
  • Patient ineligible for or has refused autologous transplant

• Adequate renal and hepatic function for age:

  • Serum creatinine <2 x ULN
  • Alanine aminotransferase (ALT, SGPT) x ULN
  • Aspartate aminotransferase (AST, SGOT) x ULN
  • Total bilirubin 5_2 x ULN except if bilirubin is elevated due to Gilbert's syndrome or hemolytic anemia
• Adequate cardiac and pulmonary function for age.
• ECOG Performance Status 0, 1, or 2 or Lansky performance scale >50% for patients <16 years of age.
• Voluntary witnessed written informed consent. Children will be asked for assent where appropriate.
• The patient, if female, must be post-menopausal, premenarcheal, or sterile, or if the patient is of childbearing potential, she must be practicing a method of birth control considered effective and medically acceptable by the investigator for a minimum of 1 month prior to study entry and at least 2 months after the study end.
• Patient must have undergone successful leukapheresis to obtain adequate antigen presenting cells.
• Any patient who enters the study in a relapse state, with evidence of end organ (pulmonary, renal, or hepatic) toxicity, or with recent recovery from infection, who may potentially have little benefit from this protocol, must have his/her eligibility status discussed with the Principal Investigator.
• Patient must have life expectancy of at least 12 weeks.

Exclusion Criteria

• Eligibility for other transplant types:

  • Patient has family donor who is matched or single antigen mismatched at HLA-A, HLA-B, HLA-DR, and HLA-DQ. Donorrecipient matching must be evaluated via both phenotype and genotype.
  • Patient has available unrelated donor who is matched at HLA-A, HLA-B, and HLA-DR. Donor-recipient matching must be evaluated via both phenotype and genotype.
• Active uncontrolled infection (continued positive blood or soft tissue cultures despite appropriate antibiotic treatment)
• Positive 13-HCG in a female of childbearing potential
• Evidence of HIV infection or known HIV positive serology
• Any prior bone marrow transplant
• A peripheral blood differential count at the time of leukapheresis with greater than 25% blasts. This exclusion criterion is valid only for the first four patients enrolled.
• Patients with Fanconi's anemia