Sirolimus & Mycophenolate Mofetil as GVHD Prophylaxis in Myeloablative, Matched Related Donor HCT

Inclusion Criteria:

* Disease Categories: (one of the following)

  * AML, age 2 - 60 years beyond 2nd remission or relapsed/refractory disease
  * AML, age 51-60 years of age, in first or subsequent remission or relapsed/refractory disease
  * AML with multilineage dysplasia
  * ALL, age 2 - 60 years beyond 2nd remission or relapsed/refractory disease
  * ALL, age 51 - 60 years in first or subsequent remission or relapsed/refractory disease
  * CML Beyond 2nd chronic phase or in blast crisis
  * MDS; Includes World Health Organization classifications of refractory anemia with excess blasts-1 (RAEB-1), RAEB-2 and therapy-related MDS
  * Myeloproliferative disorders; MDS with poor long-term survival including myeloid metaplasia and myelofibrosis
  * High risk NHL in first remission
  * Relapsed or refractory NHL
  * HL beyond first remission
* Males and females of any ethnic background 2 - 60 years of age
* Karnofsky Performance Status ≥ 70% or Lansky performance status \> 70% for patients \< 16 years of age.
* Matched related donor identified: 6/6 HLA-A, B and DRB1
* Willingness to take oral medications during the transplantation period
* Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

* Prior myeloablative allogeneic or autologous HCT
* HIV infection
* Pregnant
* Lactating females
* Evidence of uncontrolled active infection
* Organ Dysfunction:
* Serum creatinine \> 1.5 mg/dL or 24 hour creatinine clearance \< 50 ml/min
* Direct bilirubin, ALT or AST \> 2 x ULN
* In adults DLCO \< 60% predicted and in children room air oxygen saturation \< 92%
* In adults, left ventricular ejection fraction \< 45% and in children, shortening fraction \< 26%
* Fasting Cholesterol \> 300 mg/dL or Triglycerides \> 300 mg/dL while on lipid-lowering agents.
* Patients receiving investigational drugs unless cleared by the PI.
* Patients with prior malignancies except basal cell carcinoma or treated carcinoma in-situ.
* Cancer treated with curative intent \> 5 years will be allowed.
* Cancer treated with curative intent ≤ 5 years will not be allowed with PI approval.