Ultra-Low Dose IL-2 Therapy as GVHD Prophylaxis in Haploidentical Allogeneic Stem Cell Transplantation

* INCLUSION CRITERIA RECIPIENT:
* Ages 18-70 years inclusive
* Haploidentical donor available
* Any one of the following hematologic conditions meeting a standard indication for allogeneic stem cell transplant:

  * Chronic myelogenous leukemia (CML): Subjects under the age of 21 in chronic phase OR subjects ages 18-65 in chronic phase who have failed treatment with imatinib or have intolerance to imatinib OR Subjects ages 18-65 in accelerated phase or blast transformation. OR
  * Acute lymphoblastic leukemia (ALL): any of these categories: Adult ALL including standard risk. All second or subsequent remissions, primary induction failure, partially responding or untreated relapse. OR
  * Acute myelogenous leukemia (AML): AML in first remission - except AML with good risk karyotypes: AML M3 (t15; 17), AML M4Eo (inv 16), c-kit unmutated AML t (8; 21). All AML in second or subsequent remission, primary induction failure and resistant relapse. OR
  * Myelodysplasticsyndromes(MDS): any of these categories - refractory anemia with transfusion dependence, refractory anemia with ANC\<500/ (Micro)L, refractory anemia with excess of blasts, transformation to acute leukemia, chronic myelomonocytic leukemia, atypical MDS/myeloproliferative syndromes. OR
  * Myeloproliferative disorders including atypical (Ph-negative) chronic myeloid and neutrophilic leukemias, progressing myelofibrosis, and polycythemia vera, essential thrombocythemia either in transformation to acute leukemia or with progressive transfusion requirements or pancytopenia. OR
  * Non-Hodgkin s lymphoma including Mantle cell lymphoma relapsing or refractory to standard of care treatments. OR
  * Multiple myeloma, Waldenstroms macroglobulinemia, unresponsive or relapsed following standard of care treatments. OR
  * Hodgkin's Lymphoma relapsing following an autologous transplant. OR
  * Other rare hematologic malignancies for which hematopoietic stem cell transplantation has been performed and offers a durable remission or as the only option with a potential for cure.

    * Chemotherapy-resistant multisystem Langerhans cell histiocytosis (MSLCH) especially involving organs like the bone marrow, liver, spleen, and lungs
    * Aggressive systemic mastocytosis, and mast cell leukemia (MCL) in first CR (CR1)
    * Hypereosinophilic syndrome who have failed imatinib therapy or FIP1L1-PDGFRa-negative patients who develop end-organ dysfunction
    * Adult T-cell leukemia/lymphoma at first diagnosis
    * Refractory or disseminated nasal-type extranodal NK/T-lymphoma or aggressive Natural killer cell leukemia/lymphoma
    * Mycosis fungoides and S(SqrRoot)(Copyright)zary syndrome after failure of two or three initial therapies
    * Primary or relapsed refractory Angioimmunoblastic T-cell lymphoma at first diagnosis
    * Hepatosplenic T-cell lymphoma (gamma/delta T-cell lymphoma) at first diagnosis
    * T-cell prolymphocytic leukemia at first diagnosis
    * Subcutaneous panniculitic T-cell lymphoma at first diagnosis
    * Hematodermic neoplasm (blastic natural killer cell lymphoma or Blastic plasmacytoid dendritic cell neoplasm) at first diagnosis
  * Ability to comprehend the investigational nature of the study and provide informed consent.

EXCLUSION CRITERIA RECIPIENT (ANY OF THE FOLLOWING):

* HLA identical (6/6) related or (8/8 allele level matched) unrelated donor available and readily accessible at time of transplantation evaluation
* Major anticipated illness or organ failure incompatible with survival from transplant
* Severe psychiatric illness or mental deficiency sufficiently severe as to make compliance with the transplant treatment unlikely and making informed consent impossible.
* Positive pregnancy test for women of childbearing age
* Contraindication to receive IL-2 including:

  * Hypersensitivity to IL-2
  * Sustained ventricular tachycardia (\>5 beats)
  * Cardiac arrhythmias not controlled or unresponsive to management
  * Chest pain with ECG changes, consistent with angina or myocardial infarction
  * Cardiac tamponade
  * Intubation for \>72 hours
  * Renal failure requiring dialysis \>72 hours
  * Coma or toxic psychosis lasting \> 48 hours
  * Repetitive or difficult to control seizures
  * Active bowel ischemia or perforation
  * Active GI bleeding requiring surgery
* DLCO adjusted for Hb and ventilation\< 50% predicted
* Left ventricular ejection fraction \< 40% (evaluated by ECHO) or \< 30% (evaluated by MUGA)
* AST/SGOT \> 5 times ULN
* Total bilirubin \> 3 times ULN
* Estimated GFR \<60ml/min (calculated by CKD-EPI, a formula routinely used in Clinical Research Center at National Institutes of Health. In case of borderline estimated GFR, CKD-EPI creatinine-cystatin C formula will be used for more accurate estimation)
* Prior allogeneic stem cell transplantation

INCLUSION CRITERIA DONOR:

* Related donor who shares 1 haplotype with the recipient
* Age greater than or equal to 18 or less than or equal to 80 years old
* Ability to comprehend the investigational nature of the study and provide informed consent.

EXCLUSION CRITERIA DONOR (ANY OF THE FOLLOWING):

* Unfit to receive G-CSF and undergo apheresis such as abnormal blood counts, history of stroke, uncontrolled hypertension
* Sickling hemaglobinopathy including HbSS, HbAS, HbSC
* Donors who are positive for HIV, active hepatitis B (HBV), hepatitis C (HCV) or human T-cell lymphotropic virus (HTLV-I/II)
* Severe psychiatric illness. Mental deficiency sufficiently severe as to make compliance with the BMT treatment unlikely and making informed consent impossible.