Reduced Intensity Flu/Mel/TBI Conditioning for HAPLO HCT Patients With Hematologic Malignancies

Inclusion Criteria

• Age ≥ 55 years or HCT Co-Morbidity score (HCT-CI) >/=3
• Lack of a suitable 8/8 HLA-matched sibling donor
• Adequate performance status is defined as Karnofsky score ≥ 70%
• Patients and selected donor must be HLA typed at high resolution using DNA based typing at the following HLA-loci: HLA-A, -B, -C and DRB1. Donors must be HLA-haploidentical relatives including, but not limited to, children, siblings, or parents, defined as having a shared HLA haplotype between donor and patient at HLA-A, -B, -C, and -DRB1.
• Acute Myeloid Leukemia (AML): Must be in remission with morphology ( 12 months are eligible after at least two prior therapies
• Patients with primary, refractory disease. Bulky disease and an estimated tumor doubling time of less than one month require debulking therapy prior to transplant.
• Lymphoplasmacytic lymphoma is eligible after initial therapy if chemotherapy sensitive
• Adequate organ function as defined per protocol
• Sexually active females of child bearing potential and males with partners of child bearing potential must agree to use adequate birth control during study treatment

Exclusion Criteria

• Pregnant or breastfeeding
• Untreated active infection
• Active HIV infection
• Prior allogenic transplant at any time prior or less than 6 months since prior autologous transplant (if applicable)
• Active central nervous system malignancy
• Favorable risk AML defined as per protocol
• Active central nervous system malignancy
• Favorable risk AML defined as having one of the following:
• t(8, 21) without cKIT mutation or evidence of immunophenotypic, cytogenetic or molecular minimal residual disease (MRD)
• inv(16) or t(16;16) without cKIT mutation or evidence of MRD
• Normal karyotype with mutated NPM1 but FLT3-ITD wild type without evidence of MRD
• Normal karyatype with double mutated CEBPA without evidence of MRD