Mismatched Transplantation Using High-dose Post-transplant Cyclophosphamide

Inclusion Criteria

• Patients 55 and 3 abnormalities], peripheral blood blasts 55 years and /=1st chronic phase, after failed >/=2 lines of tyrosine kinase inhibitors; in accelerated or blast phase with > 30% bone marrow blasts;
• Prior allogeneic stem cell transplant more than 6 months from the first transplant, in remission.
• Chemotherapy-sensitive relapsed lymphoma (Complete or partial response), Hodgkin's or non-Hodgkin's lymphoma, no evidence of "bulky" disease (> 10 cm in diameter);
• Patients with chemo-sensitive CLL with persistent or recurrent disease after fludarabine-based regimens, no evidence of "bulky" disease (> 10 cm in diameter)
• Patients with poor prognosis multiple myeloma by cytogenetics (del13, del 17p, t(1;14) or t(14;16) or hypodiploidy, with advanced disease (stage>/=2) and /or relapsed after autologous stem cell transplant.
• Patients with myelofibrosis (Lille >0, transfusion dependency, progression to blast phase; however, in remission from AML) or chronic myelomonocytic leukemia (CMML). These patients will be treated with the reduced-intensity conditioning regimen #2 and will be subject to the same stopping rule as the group >/= 55 years or with comorbidities.
• Zubrod performance status 0-1 or Lansky PS greater or equal to 70%.
• Patients above >/=65 years old should have an age-adjusted co-morbidity index of /=50 ml/min (calculated with Cockcroft-Gault formula); Creatinine for children /= 45% predicted corrected for hemoglobin. For pediatric patients, if unable to perform pulmonary function, >/= 92% oxygen saturation with pulse oximetry.
• Left ventricular ejection fraction (LVEF) >/= 40%.
• Patient or patient's legal representative, parent(s) or guardian should provide written informed consent. Assent of a minor if participant's age is at least seven and less than eighteen years.

Exclusion Criteria

• HIV positive; active hepatitis B or C
• Patients with active infections. The PI is the final arbiter of the eligibility.
• Liver cirrhosis with greater than grade 1 stage 1 inflammation/fibrosis
• Uncontrolled central nervous system (CNS) involvement by tumor cells
• Patients with AML must have less than 30% bone marrow blasts and no peripheral blood blasts.
• History of another primary malignancy that has not been in remission for at least 3 years. (The following are exempt from the 3-year limit: non-invasive nonmelanoma skin cancer, fully excised melanoma in situ [Stage 0], curatively treated localized prostate cancer, and cervical carcinoma in situ on biopsy or a squamous intraepithelial lesion on PAP smear.)
• Positive Beta human chorionic gonadotropin (HCG) test in a woman with child bearing potential defined as not post-menopausal for 12 months or no previous surgical sterilization.
• Inability to comply with medical therapy or follow-up.