Conditions: Hematological Disease
Allocation: NON_RANDOMIZED | Intervention model: PARALLEL
Enrollment: 1
Healthy volunteers: no

Brief summary:
The primary objective of this study is to assess the rate of engraftment with combined haploidentical-cord blood transplantation in patients with pre-existing donor specific antibodies and in those with active disease.

Detailed description:
Primary Objective

\- To assess the rate of engraftment with combined haploidentical-cord blood transplantation in patients with pre-existing donor specific anti-HLA antibodies and in those with active disease

Secondary Objectives

* To determine the long term fate of the haplo transplant and the cord blood transplant in this setting.
* To describe the incidence and severity of acute and chronic GVHD.

Arms:
arm 1: Arm I contains fludarabine, melphalan, and antithymocyte globulin (ATG) arm 2: Arm II contains fludarabine, busulfan, antithymocyte globulin (ATG), and total body irradiation (TBI).

Interventions: intervention 1: Melphalan intervention 2: Fludarabine intervention 3: Antithymocyte Globulin (ATG) intervention 4: Busulfan intervention 5: Total Body Irradiation (TBI)
Intervention descriptions: intervention 1: Melphalan is given daily for 2 days, overlapping with the completion of fludarabine. intervention 2: Fludarabine is given through the vein daily for 5 days. intervention 3: ATG is given every other day for 4 days. intervention 4: Busulfan is given daily for 4 days. intervention 5: TBI is given twice on the last day.

Protocol document: