Myeloablative Hematopoietic Progenitor Cell Transplantation (HPCT) for Pediatric Malignancies

Inclusion Criteria:

Malignant Disease

Chronic myleogenous leukemia in chronic or accelerated phase

Acute lymphoblastic leukemia (ALL)

First remission high-risk ALL (Ph+, t( 4-11) infants).
Second remission ALL, after a short first remission (<36 mos from Dx).
3rd or greater remission ALL.

Acute myelogenous leukemia (AML)

First remission high risk acute nonlymphoblastic (ANLL) (as defined by cytogenetics), if a matched sibling donor is available.
Initial partial remission AML (<20% blasts in the bone marrow).
AML that is refractory to two cycles of induction therapy.
Second or greater remission AML

Myelodysplastic/Myeloproliferative Disease

Juvenile Myelomonocytic Leukemia (JMML)
Myelosplastic syndrome and/or pre-leukemia at any stage

Lymphoma

Relapsed lymphoma with residual disease that appears to be chemo-sensitive and non-bulky (<5 cm at largest diameter)
Venous Access: Three lumens of central vascular access will be required for all patients entered on protocol due to the need for a dedicated line for continuous infusion cyclosporine.
Informed Consent: The patient and/or the patient's legally authorized guardian must acknowledge in writing that consent to become a study subject has been obtained in accordance with the institutional policies approved by the U.S. Department of Health and Human Services.

Patient organ function requirements:

Adequate renal function: Serum Creatinine <~1.5 x normal, or Creatinine clearance of 70 mL/min/1.73 mE2 or an equivalent GFR as determined by the institutional normal range
Adequate liver function: Total bilirubin <1.5 x normal; and SGOT (AST) or SGPT (ALT) <~2.5 x normal
Adequate cardiac function: Shortening fraction of >/=27% by echocardiogram
Adequate pulmonary function: FEV1/FVC >/=60% by pulmonary function test; for children who are uncooperative, no evidence of dysnpea at rest, or exercise intolerance, and must have a pulse oximetry >94% in room air
Performance status: Lansky for children /= 60; Karnofsky status for those > 16 years of age >/= 70
Effective Contraceptive Use: Women of childbearing potential and sexually active males should use effective contraception while on study.

Exclusion Criteria:

Patients who are pregnant or lactating
Inability to find a suitable donor for the patient
Patient is HIV-positive
Patient has active Hepatitis B
Disease progression or relapse prior to HPC infusion