Ph II of Non-myeloablative Allogeneic Transplantation Using TLI & ATG In Patients w/ Cutaneous T Cell Lymphoma

Primary Objectives

-To evaluate the graft versus lymphoma effect by monitoring rate of clinical response, event-free and overall survival.

Secondary Objectives

-To evaluate the incidence and extent of acute and chronic graft-versus-host disease (GVHD) and time to engraftment.

Inclusion criteria

• Stage IIB-IV mycosis fungoides or Sezary syndrome, who have failed at least 1 standard systemic therapy or are not candidates for standard therapy.
• Pathology reviewed and the diagnosis confirmed at Stanford University Medical Center.
• Age > 18 years and <= 75 years.
• Karnofsky Performance Status >= 70%.
• Corrected DLCO >= 40%
• Left ventricle ejection fraction (LVEF) > 30%.
• ALT and AST must be <= 3X normal. Total bilirubin <= 3 mg/dL unless hemolysis or Gilbert's disease.
• Estimated creatinine clearance >= 50 ml/min.
• Have a related or unrelated HLA-identical donor or one antigen/allele mismatched in HLA-A, B, C or DRB1.
• Signed informed consent.
• Patients with prior malignancies diagnosed > 5 years ago without evidence of disease are eligible.
• Patients with a prior malignancy treated < 5 years ago but have a life expectancy of > 5 years for that malignancy are eligible.

Donor Inclusion Criteria

• Age >=17.
• HIV seronegative.
• No contraindication to the administration of G-CSF.
• Willing to have a central venous catheter placed for apheresis if peripheral veins are inadequate

Exclusion criteria

• Uncontrolled active infection.
• Uncontrolled congestive heart failure or angina.
• Pregnancy or nursing patients will be excluded from the study.
• Those who are HIV-positive will be excluded from the study due to high risk of lethal infection after hematopoietic cell transplantation.

Donor Exclusion Criteria

• Serious medical or psychological illness.
• Pregnant or lactating women are not eligible
• Prior malignancies within the last 5 years except for non-melanoma skin cancers