Myeloid-Derived Suppressor Cells and Checkpoint Immune Regulators' Expression in Allogeneic SCT Using FluBuATG

Inclusion criteria

• Age less than or equal to 75 years
• The patient must be approved for transplant by the treating transplant physician. This includes completion of their pretransplant workup, as directed by standard Dartmouth-Hitchcock Medical Center (DHMC) Standard Operating Procedures (SOPs). DHMC SOP for Pretransplant Evaluation of allogeneic recipient.
• The patient must have a disease, listed below, with treatment responsiveness that the treating transplant physician believes will benefit from an allogeneic stem cell transplant. The diseases include:

• Acute leukemia AML (Acute Myeloid Leukemia), ALL (Acute Lymphoid Leukemia)
• Chronic leukemia CML (Chronic Myeloid Leukemia), CLL (Chronic Lymphoid Leukemia)
• Myelodysplasia
• Myelofibrosis
• Lymphoma NHL (Non-Hodgkin's Lymphoma) and Hodgkin's disease
• Plasma cell disorder, including myeloma, Waldenstrom's Macroglobulinemia
• Donor availability- the patient must have an identified donor

• Sibling Availability of a 6 out of 6 identical donor
• Unrelated donor: Availability of a 6 out of 6 unrelated donor
• No human immunodeficiency virus (HIV) infection or active hepatitis B or C
• Easter Cooperative Oncology Group (ECOG) performance status 0, 1, or 2
• Diffusing capacity of the lungs for carbon monoxide DLCO more than or equal to 40 percent predicted
• Left ventricular ejection fraction more than or equal to 35 percent
• Serum bilirubin less than 2x upper limit of normal transaminases less than 3x normal at the time of transplant
• No active or uncontrollable infection
• In female, a negative pregnancy test if experiencing menstrual periods
• No major organ dysfunction precluding transplantation
• No evidence of an active malignancy that would limit the patient's survival to less than 2 years. If there is any question, the principal investigator can make a decision.

Exclusion criteria

• Psychiatric disorder or a mental deficiency of the patient that is sufficiently severe to make compliance with the treatment unlikely, and making informed consent impossible.
• Major anticipated illness or organ failure incompatible with survival from bone marrow transplant.
• History of refractory systemic infection

Donor eligibility

• Human leukocyte antigen (HLA) 6 out of 6 matched related or unrelated donor.
• The donor must be healthy and must be willing to serve as a donor, based on standard guidelines
• The donor must have no significant comorbidities that would put the donor at marked increased risk
• There is no age restriction for the donor
• Informed consent must be signed by donor, if sibling donor, or by third party if unrelated donor.

Donor Exclusion Criteria

• The National Marrow Donor Program (NMDP) guidelines for exclusion criteria will be used. In addition, the following donors are NOT eligible:
• Syngeneic donor
• Pregnant or lactating donor
• Human immunodeficiency virus (HIV) or active HepB or C in the donor
• Donor unfit to receive Granulocyte-colony stimulating factor (GCSF) and undergo apheresis
• A donor with a psychiatric disorder or mental deficiency that makes compliance with the procedure unlikely and informed consent impossible