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.