Induction Of Mixed Hematopoietic Chimerism In Older Patients With B-Cell Malignancies and in Selected Other Diseases, Using Low Dose TBI , PBSC Infusion And Post-Transplant Immunosuppression With Cyclosporine And Mycophenolate Mofetil to be Followed by Donor Lymphocyte Infusion: A Pilot Study.

Inclusion Criteria:

- Patients aged > 49 years and < 66 years with NHL, CLL and multiple myeloma who are
not eligible for autologous transplantation or have failed prior autologous
transplantation; patients with NHL and CLL must have failed prior therapy with an
alkylating agent and/or fludarabine; patients with multiple myeloma must have stage
II or III disease and received prior chemotherapy

- Patients < 50 years of age with NHL, CLL and multiple myeloma at high risk of regimen
related toxicity through prior autologous transplant or through pre-existing chronic
disease affecting kidneys, liver, lungs, and heart will be considered on a case by
case basis and presented to professional clinical counselor (PCC)

- Patients < 66 years of age with other diseases treatable by allogeneic BMT whom
through pre-existing chronic disease affecting kidneys, liver, lungs, and heart are
considered to be at high risk for regimen related toxicity using standard high dose
regimens; autografting must also be contraindicated in these patients and they must
be approved for this protocol by both PCC and by the principle investigator; the
following diseases are the likely candidates but other less common diseases may be
considered and approved by PCC:

- Myelodysplastic syndromes

- Myeloproliferative syndromes

- Acute leukemia in remission

- Chronic myelogenous leukemia (CML) in 2nd chronic phase

- Hodgkin's disease

- Selected patients with any of the above diagnosis who are (a) older than 65 years and
< 75 years with a Karnofsky score > 70 and who, apart from age, fulfill eligibility
criteria, or (b) < 66 years but ineligible solely because of renal dysfunction; these
patients must be approved for transplant by both PCC and the principal investigator

- DONOR: Human leukocyte antigen (HLA) genotypically identical sibling

- DONOR: Donor must consent to filgrastim (G-CSF) administration and leukapheresis

- DONOR: Donor must have adequate veins for leukapheresis or agree to placement of
central venous catheter (femoral, subclavian)

- DONOR: Age < 75

Exclusion Criteria:

- Eligible for autologous transplantation

- Patients with rapidly progressive high grade NHL

- History of central nervous system (CNS) involvement with disease

- Fertile men or women unwilling to use contraceptive techniques during and for 12
months following treatment

- Females who are pregnant

- Patients with a creatinine clearance < 50 ml/min

- Cardiac ejection fraction < 40% or cardiac failure requiring therapy

- Severe defects in pulmonary function testing (defects are currently categorized as
mild, moderate and severe) as defined by the pulmonary consultant, or receiving
supplementary continuous oxygen

- Total bilirubin > 2 x the upper limit of normal

- Serum glutamic pyruvate transaminase (SGPT) and serum glutamic oxaloacetic
transaminase (SGOT) 4 x the upper limit of normal

- Karnofsky score < 50

- Patients with poorly controlled hypertension

- DONOR: Identical twin

- DONOR: Age less than 12 years

- DONOR: Pregnancy

- DONOR: Infection with human immunodeficiency virus (HIV)

- DONOR: Inability to achieve adequate venous access

- DONOR: Known allergy to G-CSF

- DONOR: Current serious systemic illness

- DONOR: Failure to meet Fred Hutchinson Cancer Research Center (FHCRC) criteria for
donation as described in the Standard Practice Guidelines