Identify Barriers to Allogeneic Hematopoietic Stem Cell Transplantation in Patients With Newly Diagnosed and Relapsed Acute Leukemia

Inclusion Criteria:

Patients with newly diagnosed or relapsed acute leukemia. Patients undergoing reinduction due to primary induction failure are also eligible. Patients with acute leukemia will be enrolled to Arm A
Patients with diagnosis of MDS, MPN and MDS/MPN overlap who meet any of the following criteria (based on NCCN guidelines):
Clinically significant cytopenia of at least 2 cell lines affected; Hgb<10,
Platelet<100,000, absolute neutrophil count<1000
Bone marrow blasts >5% and any level of circulating blasts
Evidence of disease progression or no response to hypomethylating agents/immunosuppressive treatment or a clinical trial.
IPSS Intermediate-1 and higher
IPSS-R intermediate and higher
All cases of therapy related MDS with excess blasts
In patients with Myelofibrosis: Low risk disease by DIPSS with either refractory, transfusion dependent anemia, circulating blasts cells greater than 2%; or adverse cytogenetics and any patient with DIPSS-intermidiate 1 and higher.
Patients with acute leukemia or MDS/MPN who relapse after first allografts. Patients with post-transplant relapse will be enrolled to Arm C.
Patients 18 years of age or older and 80 years of age or younger
For the purposes of this protocol "relapse" is defined as re-emergence of the initial abnormal myeloid blast population (or blast equivalent) comprising 5% or more of marrow WBC or any amount prompting a therapeutic intervention targeting relapsed disease, including, but not limited to withdrawal of immunosuppression, targeted therapies, chemotherapy, etc.

Exclusion Criteria:

Patients with polycythemia vera (PV) and essential thrombocytosis (ET)