cyclophosphamide for prevention of graft-versus-host disease after allogeneic peripheral blood stem cell transplantation in patients with hematological malignancies

Conditions: Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Myeloid Leukemia in Remission; Adult Erythroleukemia (M6a); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Adult Pure Erythroid Leukemia (M6b); Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Blastic Phase Chronic Myelogenous Leukemia; Childhood Acute Erythroleukemia (M6); Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Megakaryocytic Leukemia (M7); Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Myelomonocytic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Philadelphia Chromosome Negative Chronic Myelogenous Leukemia; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Relapsing Chronic Myelogenous Leukemia; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage III Multiple Myeloma; Testicular Lymphoma; Waldenström Macroglobulinemia

Summary: this phase ii trial studies how well cyclophosphamide works in preventing chronic graft-versus-host disease after allogeneic peripheral blood stem cell transplant in patients with hematological malignancies. giving chemotherapy and total-body irradiation before transplantation helps stop the growth of cancer cells and prevents the patient's immune system from rejecting the donor's stem cells. healthy stem cells from a donor that are infused into the patient help the patient's bone marrow make blood cells; red blood cells, white blood cells, and platelets. sometimes, however, the transplanted donor cells can cause an immune response against the body's normal cells, which is called graft-versus-host disease (gvhd). giving cyclophosphamide after transplant may prevent this from happening or may make chronic gvhd less severe.

primary objectives: i. the primary objective of this study is to assess outcomes when high-dose cyclophosphamide (cy) is administered on days 3 and 4 followed by cyclosporine (csp) after human leukocyte antigen (hla)-matched related or unrelated mobilized blood cell transplantation with total-body irradiation (tbi) or busulfan (bu)-based conditioning. secondary objectives: i. the secondary objective of this study is to assess hematopoietic cell transplantation (hct) outcomes when withdrawal of csp is accelerated in patients without acute graft-versus-host disease (gvhd). outline: patients' conditioning regimens are determined by the clinical coordinator after consultation with the attending physician. based on disease, patients receive either tbi or fludarabine and busulfan. preparative regimen: patients receive tbi twice daily (bid) on days -4 or -3 to -1. some patients also receive fludarabine intravenously (iv) daily on days -5 to -2 and busulfan iv over 3 hours once daily (qd) or over 2 hours every 6 hours on days -5 to -2. patients may also undergo central nervous system (cns) prophylaxis, testicular irradiation, and/or involved field irradiation as per standard practice. transplantation: patients undergo allogeneic peripheral blood stem cell transplantation (pbsct) on day 0 per standard practice. gvhd prophylaxis: patients receive cyclophosphamide iv over 1-2 hours on days 3-4. patients also receive cyclosporine iv every 12 hours or every 8 hours beginning on day 5 with taper on days 56-126. treatment continues in the absence of disease progression or unacceptable toxicity. after completion of study treatment, patients are followed up at day 180 and then annually for 5 years.

Eligibility criteria:
inclusion criteria: * acute lymphocytic leukemia (all) in morphologic first complete remission (cr1) with high risk features defined as, but not limited to: evidence of adverse cytogenetics such as t(9;22), t(1;19), t(4;11), or mixed-lineage leukemia (mll) rearrangements; presence of minimal residual disease; progenitor b-cell immunophenotype; high white blood cells (wbc) at diagnosis (\> 30,000/ul in b-all; \> 100,000/ul in t-all); or delayed attainment of cr (\> 4 weeks) after induction therapy; additional clinical characteristics deemed to confer a high relapse risk may be discussed with and approved by the principal investigator (pi) * acute myeloid leukemia (aml) in cr1 except patients with low-risk features defined as: * inv 16 or t(8;21) in the absence of c-kit mutations * normal karyotype who are flt3-itd-negative and npm1-positive in the absence of c-kit mutations * patients with respective "low-risk" features are eligible, however, if (i) more than 1 cycle of induction therapy was required to achieve cr1 (ii) the patient had a preceding myelodysplastic syndrome (mds) other than myelofibrosis, or (iii) secondary aml * acute leukemia in 2nd or greater cr (cr \>= 2) * refractory or relapsed aml with =\< 10% bone marrow blasts and no circulating blasts or proven extramedullary disease * aml transformed from myelodysplastic syndrome (mds) with \< 10% bone marrow blasts * mds with following high risk features: * high risk cytogenetics (including, but not limited to: 7q--, inv\[3\], t\[3q\], del\[3q\] or complex karyotype) * international prognostic scoring system (ipss) intermediate (int)-2 or greater * treatment-related mds * any phase of mds if patient is \< 21 years of age * chronic myelogenous leukemia (cml) beyond 1st chronic phase or resistant or intolerant to tyrosine kinase inhibitors (adults) or any phase (pediatric \< 21 years) * chronic myelomonocytic leukemia * philadelphia-negative myeloproliferative disorder * lymphoma: relapsed chemotherapy-sensitive (complete or partial response) hodgkin or non-hodgkin lymphoma * multiple myeloma-stage iii * the patient or legal representative must be able to understand and give written informed consent * donors: the donor must be a genotypically hla-identical sibling, a phenotypically hla-matched first-degree relative, or an unrelated donor who is molecularly matched with the patient at hla-a, b, c, drb1 * donors: donors must meet the selection criteria for administration of g-csf (filgrastim) and apheresis defined by the foundation for the accreditation of cell therapy (fact) and will be screened per the american association of blood banks (aabb) * donors: donors must be capable of giving informed consent exclusion criteria: * prior autologous or allogeneic stem cell transplant * performance status \> 2 (eastern cooperative oncology group \[ecog\]) or \< 50 (lansky; for patients \< 16 years old) * uncontrolled infection; the protocol principal investigator (pi) will be final arbiter if there is uncertainty regarding whether a previous infection is under adequate control to allow enrollment in the study * positive serology for human immunodeficiency virus (hiv)-1, 2 or human t cell lymphotropic virus (htlv)-1, 2 * left ventricular ejection fraction \< 45% or shortening fraction \< 25%; no uncontrolled arrhythmias or symptomatic cardiac disease * symptomatic pulmonary disease; forced expiratory volume in one second (fev1), forced vital capacity (fvc), diffusion capacity of the lung for carbon monoxide (dlco) =\< 50% of predicted (corrected for hemoglobin); if pulmonary function tests cannot be performed, an oxygen saturation \< 92% on room air * calculated (cockcroft-gault or appropriate calculation for pediatric patients) serum creatinine clearance =\ 60 ml/min, this measurement is acceptable * total serum bilirubin more than twice upper normal limit * alanine aminotransferase (alt) or aspartate aminotransferase (ast) more than 3-fold higher than laboratory upper normal limits * female patient must have negative serum pregnancy test (all women of child bearing-potential must have test performed) * donors: potential donors who for psychological, physiological, or medical reasons cannot tolerate administration of g-csf or apheresis * donors: donors who are allergic to filgrastim or escherichia (e.) coli-derived proteins * donors: donor-related risks to recipients * donors: positive anti-donor lymphocytotoxic crossmatch * donors: donors who are positive for hiv