A Research Study of Bone Marrow Transplantation From Unrelated or Partially Matched Related Donors

Inclusion criteria

• ✓. Any patient with a hematological or oncological diagnosis in which allogeneic hematopoietic stem cell transplantation (HSCT) is thought to be beneficial.
• ✓. Patients without morphological or molecular evidence of disease
• ✓. For patients with "indolent diseases," if the patient has evidence of disease the disease burden must be minimal (at least PR) and the disease must be chemoresponsive. Thus for example patients with acute leukemia (not an indolent disease) must be in a morphological CR or CRp.
• ✓. For patients with MDS the inclusion criteria is specifically as follows:
• ✓. Patients must have a related donor who is zero, one, two, three, or four antigen mismatched at the HLA-A; B; C; DR loci or an unrelated donor up to a two antigen mismatch. DNA will be retained by the tissue typing laboratory for possible typing for DQ and DP. When multiple related donor options are available donor selection will be determined the same as in the TJU two-step protocols. When multiple unrelated donors are available care will be made to avoid HLA-A and HLA-B mismatches if possible based on data from the Japanese Marrow Donor Registry studies. An HLA antibody screen will be performed on each patient.
• ✓. All patients must have adequate organ function:
• ✓. Patients with related donors must have an LVEF of \>35%. Patients with unrelated donors must have an LVEF \>45%. Patients with LVEF ≤50% and all patients with symptoms or history of heart failure or coronary artery disease must have a stress echo or equivalent test and a cardiological evaluation.
• ✓. Patients with related donors must have a DLCO \>35% of predicted corrected for hemoglobin. Patients with unrelated donors must have a DLCO \>45% of predicted corrected for hemoglobin. For related donors if the DLCO is less than 45% the EF must be greater than 45% and vice versa.

Exclusion criteria