Sirolimus, Tacrolimus, and Antithymocyte Globulin in Preventing Graft-Versus-Host Disease in Patients Undergoing a Donor Stem Cell Transplant For Hematological Cancer

DISEASE CHARACTERISTICS:

* Diagnosis of hematological malignancy including any of the following:

  * Non-Hodgkin lymphoma (NHL) in any complete remission (CR) or partial response (PR)
  * Hodgkin lymphoma in any CR or PR
  * Acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) in any CR

    * Bone marrow blasts \< 20% within 4 weeks of transplant and peripheral blood absolute blast count \< 500/µL on the day of initiation of conditioning for patients with non-CR AML or ALL
  * Myelodysplastic syndromes (MDS) treated or untreated
  * Chronic myelogenous leukemia (CML) in chronic or accelerated phase
  * Multiple myeloma in any CR or PR
  * Chronic lymphocytic leukemia in CR or PR 2 or greater
  * Myelofibrosis and other myeloproliferative disorders

    * Bone marrow blasts \< 20% within 4 weeks of transplant and peripheral blood absolute blast count \< 500/µL on the day of initiation
* High-risk disease defined as AML or ALL \> CR1, accelerated phase CML, recurrent aggressive lymphoma, or active lymphoproliferative disease at transplant
* Low-risk disease defined as AML or ALL in CR1, chronic phase CML, or low-grade lymphoproliferative disorder with controlled disease at transplant
* Must be planning to receive 1 of the following conditioning regimens at City of Hope:

  * Fludarabine phosphate and melphalan for patients with hematological malignancies and contraindications for conventional myeloablative regimens due to age, co-morbidity, or previous transplant
  * Fractionated total-body irradiation (FTBI) and etoposide for patients with AML and ALL or CML in accelerated phase
  * FTBI and cyclophosphamide for patients with NHL, AML, CML, and MDS
* Suitable unrelated donor available

  * HLA-matched or mismatched
  * Peripheral blood stem cells available
  * No bone marrow or ex vivo-engineered or processed graft (e.g., CD34-positive, T-cell depletion)
* No uncontrolled CNS disease

PATIENT CHARACTERISTICS:

* Karnofsky performance status (PS) 70-100% or ECOG PS 0-2
* Creatinine \< 1.3 mg/dL or creatinine clearance ≥ 70 mL/min
* Ejection fraction \> 45%
* Direct bilirubin \< 3 times upper limit of normal (ULN)
* ALT and AST \< 3 times ULN
* Forced vital capacity, FEV1, and DLCO \> 45% of predicted
* Able to cooperate with oral medication intake
* No active donor or recipient serology positive for HIV
* No known contraindication to administration of sirolimus, tacrolimus, or anti-thymocyte globulin
* No active hepatitis B or C
* Negative pregnancy test

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* Concurrent participation in other clinical trials for prevention or treatment of viral, bacterial, or fungal disease allowed provided agents do not interact with agents used in the current study