New hope for kids after transplant: study tests safer GVHD prevention

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion criteria Diagnosis: * Patients with high risk acute lymphoblastic leukemia in first remission. Examples include, but are not limited to, patients with certain leukemic cell cytogenetic findings (e.g. t(9;22) or t(4;11)); delayed response to induction chemotherapy; re-emergence of leukemic blasts by MRD (at any level) in patients previously MRD negative; persistently detectable MRD at lower levels; early T-cell precursor (ETP) ALL. * Patients with acute lymphoblastic leukemia beyond first remission. * Patients with Hodgkin's disease beyond first remission or with refractory disease. * Patients with chronic myelogenous leukemia. * Patients with primary or secondary myelodysplastic syndrome. * Patients with Non-Hodgkin's lymphoma beyond first remission or with refractory disease. * Patients with de novo acute myeloid leukemia in or beyond first remission or with relapsed or refractory disease, or myeloid sarcoma (extra-medullary AML). * Patients with secondary acute myeloid leukemia. * NK cell lymphoblastic leukemia in any CR. * Biphenotypic, bilineage, or undifferentiated leukemia. * Juvenile Myelomonocytic Leukemia (JMML) * All patients with prior evidence of CNS leukemia must be treated and be in CNS CR. Patients must have a related or unrelated donor matched at 12 of 12 HLA alleles. Patient must have a Karnofsky/Lansky score of 70 or higher. Patients must be 12 years of age or older. Patients must have a shortening fraction \>26% or left ventricular ejection fraction \>40%. Patients must have bilirubin less than or equal to 2.5 mg/dL and alanine aminotransferase (ALT) less than or equal to 5 times the upper limit of normal. Patients must have creatinine clearance, or a glomerular filtration rate (GFR), greater than 70 mL/min/1.73m2. Patients must be free of severe infection that upon determination of principal investigator precludes BMT. Patients must have FVC \>50% predicted OR, if unable to perform pulmonary function testing, must maintain pulse oximetry oxygen saturation \>92% on room air. Female patients of childbearing age must have a negative pregnancy test. Exclusion criteria * Patients who have undergone prior HCT. * Patients who have a peripheral blood stem cell graft source. * Patients who have a non-permissive mismatch at the DPB1 allele. * Patients who are HIV positive. * Patients positive for Hepatitis B surface antigen (HBsAg). * Patients positive for Hepatitis C. * Patients with latent tuberculosis with positive TB IFN gamma release assay.