Sirolimus & Mycophenolate Mofetil as GVHD Prophylaxis in Myeloablative, Matched Related Donor HCT

Inclusion Criteria:

Disease Categories: (one of the following)

AML, age 2 - 60 years beyond 2nd remission or relapsed/refractory disease
AML, age 51-60 years of age, in first or subsequent remission or relapsed/refractory disease
AML with multilineage dysplasia
ALL, age 2 - 60 years beyond 2nd remission or relapsed/refractory disease
ALL, age 51 - 60 years in first or subsequent remission or relapsed/refractory disease
CML Beyond 2nd chronic phase or in blast crisis
MDS; Includes World Health Organization classifications of refractory anemia with excess blasts-1 (RAEB-1), RAEB-2 and therapy-related MDS
Myeloproliferative disorders; MDS with poor long-term survival including myeloid metaplasia and myelofibrosis
High risk NHL in first remission
Relapsed or refractory NHL
HL beyond first remission
Males and females of any ethnic background 2 - 60 years of age
Karnofsky Performance Status ≥ 70% or Lansky performance status > 70% for patients < 16 years of age.
Matched related donor identified: 6/6 HLA-A, B and DRB1
Willingness to take oral medications during the transplantation period
Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

Prior myeloablative allogeneic or autologous HCT
HIV infection
Pregnant
Lactating females
Evidence of uncontrolled active infection
Organ Dysfunction:
Serum creatinine > 1.5 mg/dL or 24 hour creatinine clearance < 50 ml/min
Direct bilirubin, ALT or AST > 2 x ULN
In adults DLCO < 60% predicted and in children room air oxygen saturation < 92%
In adults, left ventricular ejection fraction < 45% and in children, shortening fraction < 26%
Fasting Cholesterol > 300 mg/dL or Triglycerides > 300 mg/dL while on lipid-lowering agents.
Patients receiving investigational drugs unless cleared by the PI.
Patients with prior malignancies except basal cell carcinoma or treated carcinoma in-situ.
Cancer treated with curative intent > 5 years will be allowed.
Cancer treated with curative intent ≤ 5 years will not be allowed with PI approval.