Sirolimus and Mycophenolate Mofetil in Preventing GVHD in Patients With Hematologic Malignancies Undergoing HSCT

Inclusion Criteria:

Subjects must have one of the following disease categories:

Acute myeloid leukemia (AML) beyond 2nd remission or relapsed/refractory disease
Acute lymphoblastic leukemia (ALL) beyond 2nd remission or relapsed/refractory disease
Chronic myeloid leukemia (CML) beyond 2nd chronic phase or in blast crises
Myelodysplastic syndrome (MDS)
Myeloproliferative disorders including myeloid metaplasia and myelofibrosis
High risk non-Hodgkin's lymphoma (NHL) in first remission
Relapsed or refractory NHL
Hodgkin's lymphoma (HL) beyond first remission
Performance status by Karnofsky of >= 70% or Lansky > 70% for patients < 16 years of age
Human leukocyte antigen (HLA) mismatched related or unrelated donor identified 8/10 or 9/10
Willingness to take oral medications during the transplantation period
Willingness and ability to sign a written informed consent (assent if applicable)

Exclusion Criteria:

Prior myeloablative allogeneic or autologous HSCT
Human immunodeficiency virus (HIV) infection
Pregnant or lactating females
Evidence of uncontrolled active infection
Down syndrome
Serum creatinine (CR) < 1.5mg/dl or 24 hour CR clearance < 50 ml/min
Direct bilirubin > 2 x upper limit of normal (ULN)
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2 x ULN
Carbon monoxide diffusing capability test (DLCO) > 60% predicted and in children- room air oxygen saturation > 92%
Left ventricular ejection fraction < 45% and in children-shortening fraction < 26%
Fasting cholesterol > 300 mg/dl or triglycerides > 300 while on lipid lowering agents
Patients who have received an investigational drug within 30 days of enrollment in study
Patients with prior malignancies except basal cell carcinoma or treated carcinoma in-situ; cancer treated with curative intent > 5 years will be allowed; cancer treatment with curative intent =< 5 years will not be allowed