Sirolimus & Mycophenolate Mofetil as GVHD Prophylaxis in Myeloablative, Matched Related Donor HCT

Inclusion Criteria: Disease Categories: (one of the following) AML, age 2 - 60 years beyond 2nd remission or relapsed/refractory disease AML, age 51-60 years of age, in first or subsequent remission or relapsed/refractory disease AML with multilineage dysplasia ALL, age 2 - 60 years beyond 2nd remission or relapsed/refractory disease ALL, age 51 - 60 years in first or subsequent remission or relapsed/refractory disease CML Beyond 2nd chronic phase or in blast crisis MDS; Includes World Health Organization classifications of refractory anemia with excess blasts-1 (RAEB-1), RAEB-2 and therapy-related MDS Myeloproliferative disorders; MDS with poor long-term survival including myeloid metaplasia and myelofibrosis High risk NHL in first remission Relapsed or refractory NHL HL beyond first remission Males and females of any ethnic background 2 - 60 years of age Karnofsky Performance Status ≥ 70% or Lansky performance status > 70% for patients < 16 years of age. Matched related donor identified: 6/6 HLA-A, B and DRB1 Willingness to take oral medications during the transplantation period Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: Prior myeloablative allogeneic or autologous HCT HIV infection Pregnant Lactating females Evidence of uncontrolled active infection Organ Dysfunction: Serum creatinine > 1.5 mg/dL or 24 hour creatinine clearance < 50 ml/min Direct bilirubin, ALT or AST > 2 x ULN In adults DLCO < 60% predicted and in children room air oxygen saturation < 92% In adults, left ventricular ejection fraction < 45% and in children, shortening fraction < 26% Fasting Cholesterol > 300 mg/dL or Triglycerides > 300 mg/dL while on lipid-lowering agents. Patients receiving investigational drugs unless cleared by the PI. Patients with prior malignancies except basal cell carcinoma or treated carcinoma in-situ. Cancer treated with curative intent > 5 years will be allowed. Cancer treated with curative intent ≤ 5 years will not be allowed with PI approval.