Donor Peripheral Stem Cell Transplant and Donor Natural Killer Cell Transplant After Total-Body Irradiation, Thiotepa, Fludarabine, and Muromonab-CD3 in Treating Patients With Leukemia or Other Blood Diseases
Graft Versus Host Disease, Leukemia, Myelodysplastic Syndromes
About this trial
This is an interventional treatment trial for Graft Versus Host Disease focused on measuring graft versus host disease, adult acute lymphoblastic leukemia in remission, recurrent adult acute lymphoblastic leukemia, childhood acute lymphoblastic leukemia in remission, recurrent childhood acute lymphoblastic leukemia, adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia in remission, recurrent adult acute myeloid leukemia, childhood acute myeloid leukemia in remission, recurrent childhood acute myeloid leukemia, secondary acute myeloid leukemia, de novo myelodysplastic syndromes, previously treated myelodysplastic syndromes, secondary myelodysplastic syndromes, accelerated phase chronic myelogenous leukemia, blastic phase chronic myelogenous leukemia, childhood chronic myelogenous leukemia, relapsing chronic myelogenous leukemia, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(15;17)(q22;q12), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), childhood myelodysplastic syndromes
Eligibility Criteria
DISEASE CHARACTERISTICS:
Diagnosis of 1 of the following life-threatening hematological malignancies:
Acute lymphoblastic leukemia meeting 1 of the following criteria:
- Advanced beyond first remission
In first remission with high-risk prognostic features, including any of the following:
- Philadelphia chromosome-positive disease
- Chromosome 11q23 abnormality
- Hypodiploid
- Failed to achieve first remission within 1 month after induction
Acute myeloid leukemia (AML) meeting 1 of the following criteria:
- Advanced beyond first remission
First remission with high-risk prognostic features, including any of the following:
- Chromosome 11q23 abnormality
- Chromosome del 7q
- Secondary AML
- Failed to achieve first remission within 1 month after induction
- Myelodysplastic syndromes with International Prognostic Score > 1
- Chronic myelogenous leukemia in accelerated or blastic phase
- No active CNS disease
- No suitable HLA-matched related or unrelated donor available
Haploidentical family member available as donor of partially HLA-matched peripheral blood stem cells
- Least degree of mismatch to HLA-A, B, C, DRB1, and DQB1
- No mismatch for a single HLA-A, B, C, DRB1, or DQB1 antigen
- Donor killer cell immunoglobulin-like receptor ligand group expression preferably different than patient
PATIENT CHARACTERISTICS:
- LVEF ≥ 45%
- DLCO ≥ 60% of predicted
- AST and ALT ≤ 2 times upper limit of normal (ULN) (unless due to malignancy)
- Bilirubin ≤ 2 times ULN (unless due to malignancy)
- No life expectancy < 6 months due to coexisting disease other than the malignancy
- No active infection (e.g., polymerase chain reaction [PCR] evidence for cytomegalovirus, human herpes virus 6, or invasive fungal infection)
- No prior infections without evidence of resolution by PCR or imaging studies within the past 2 months
- No hypersensitivity to murine antibodies
- No known HIV positivity
- Not pregnant or nursing
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
- No prior marrow transplantation with total body irradiation > 400 cGy
- No concurrent therapies for seizure disorder
- No growth factors for 21 days after transplantation
Sites / Locations
- Seattle Cancer Care Alliance
- Fred Hutchinson Cancer Research Center