Sirolimus With Tacrolimus for Graft-vs-Host Disease Prophylaxis After Un-Related Stem Cell Transplantation

Inclusion Criteria:

• Acute myelogenous leukemia(AML) in first or subsequent remission, in untreated first relapse or any treated relapse.
• Acute lymphoblastic leukemia(ALL) in first or subsequent remission, in untreated first relapse or any treated relapse.
• Chronic myelogenous leukemia in first or second chronic stable phase or in accelerated phase.
• Myelodysplastic syndromes or myeloproliferative diseases
• Non-Hodgkin's lymphoma or Hodgkin's disease in second or greater complete remission, in partial remission, or induction failure.
• Chronic lymphocytic leukemia, Rai stage 2-4, which has progressed after initial therapy.
• Matched unrelated donor.
• Age 18-55 years at the time of stem cell transplantation
• ECOG performance status 0-2
• Life expectancy of 100 days without stem cell transplantation
• Total bilirubin < 2.0 mg/dl
• AST < 90 IU
• Serum creatinine < 2.0 mg/dl
• Ejection fraction > 40% by echocardiogram or gated nuclear medicine study.

Exclusion Criteria:

• Uncontrolled infection
• Forced vital capacity or DLCO < 50% predicted for age
• Uncontrolled hypertension
• Prior hematopoietic stem cell transplant
• Evidence of HIV infection or active Hepatitis B or C infection
• Cholesterol > 300 mg/dl
• Relapsed aggressive Burkitt's or Burkitt's-like lymphoma