Palifermin With Leuprolide Acetate for the Promotion of Immune Recovery Following Total Body Irradiation Based T-Cell Depleted Allogeneic Hematopoietic Stem Cell Transplantation

Inclusion Criteria:

Treatment Portion:

* AML in 1st remission - for patients whose AML does not have "good risk" cytogenetic features (i.e. t (8;21), t(15;17), inv 16 without c-kit mutations).
* Acute leukemias of ambiguous lineage in ≥ 1st remission
* Secondary AML in remission
* AML in ≥ 2nd remission
* ALL in 1st remission with clinical or molecular features indicating a high risk for relapse; or ALL ≥ 2nd remission
* CML failing to respond to or not tolerating imatinib, dasatinib or nilotinib in first chronic phase of disease; CML in accelerated phase, second chronic phase, or in CR after accelerated phase or blast crisis.
* Non-Hodgkins lymphoma with chemo responsive disease in any of the following categories:

intermediate or high grade lymphomas who have failed to achieve a first CR or have relapsed following a 1st remission who are not candidates for autologous transplants.

b.ii. any NHL in remission which is considered not curable with chemotherapy alone and not eligible/appropriate for autologous transplant.

* Myelodysplastic syndrome (MDS): RA/RCMD with high risk cytogenetic features or transfusion dependence, RAEB-1 and RAEB-2
* Chronic myelomonocytic leukemia: CMML-1 and CMML-2.
* Patient's age is ≥18 or ≤60 years old
* Patients must have a Karnofsky (adult) or Lansky (pediatric) Performance Status ≥ 70%
* Patients must have adequate organ function measured by:

Cardiac: asymptomatic or if symptomatic then LVEF at rest must be \> 50% and must improve with exercise.

* Pulmonary: asymptomatic or if symptomatic, DLCO \> 60% of predicted (corrected for hemoglobin)
* Hepatic: \< 3xULN ALT and \< 1.5 total serum bilirubin, unless there is congenital benign hyperbilirubinemia
* Renal: serum creatinine \< 1.2 mg/dL or if serum creatinine is outside the normal range, the CrCl \> 50 ml/min (measured or calculated/estimated)
* Patients have a plan to receive a CD34-selected peripheral blood stem cell transplant with TBI-based conditioning.

Exclusion Criteria:

* Active extramedullary disease
* Active and uncontrolled infection at time of transplantation
* Patients who have undergone a prior allogeneic or autologous stem cell transplant within the previous six months.
* Pregnant or breast feeding
* HIV infection
* Patient is felt to not be a candidate for TBI by the BMT service

Donor Inclusion Criteria:

* Donor must be willing and able to undergo PBSC collection.