Cord Blood Transplantation for Patients With Cancer

Combined Transplantation of Unmanipulated Haploidentical and a SingleCord Blood Unit for Patients With Hematologic Malignancies

The primary objective of this study is to assess the rate of engraftment with combined haploidentical-cord blood transplantation in patients with pre-existing donor specific antibodies and in those with active disease.

Primary Objective

- To assess the rate of engraftment with combined haploidentical-cord blood transplantation in patients with pre-existing donor specific anti-HLA antibodies and in those with active disease

Secondary Objectives

• To determine the long term fate of the haplo transplant and the cord blood transplant in this setting.
• To describe the incidence and severity of acute and chronic GVHD.

Inclusion Criteria:

• Relapsed or refractory acute leukemia (myeloid or lymphoid)
• Acute leukemia in first remission at high-risk for recurrence
• Chronic myelogenous leukemia in accelerated phase or blast-crisis
• Chronic myelogenous leukemia in chronic phase
• Recurrent or refractory malignant lymphoma or Hodgkin lymphoma
• Chronic lymphocytic leukemia, relapsed or with poor prognostic features
• Multiple myeloma
• Myelodysplastic syndrome
• Chronic myeloproliferative disease
• Hemoglobinopathies
• Aplastic anemia

Exclusion Criteria:

• Zubrod performance status > 2
• Life expectancy is severely limited by concomitant illness
• Patients with severely decreased LVEF or impaired pulmonary function tests
• Estimated Creatinine Clearance <50 ml/min
• Serum bilirubin> 2.0 mg/dl or SGPT >3 x upper limit of normal
• Evidence of chronic active hepatitis or cirrhosis
• HIV-positive
• Patient is pregnant
• Patient or guardian not able to sign informed consent