Myeloablative Hematopoietic Progenitor Cell Transplantation (HPCT) for Pediatric Malignancies

Inclusion Criteria:

- Malignant Disease

- Chronic myleogenous leukemia in chronic or accelerated phase

- Acute lymphoblastic leukemia (ALL)

- First remission high-risk ALL (Ph+, t( 4-11) infants).

- Second remission ALL, after a short first remission (<36 mos from Dx).

- 3rd or greater remission ALL.

- Acute myelogenous leukemia (AML)

- First remission high risk acute nonlymphoblastic (ANLL) (as defined by
cytogenetics), if a matched sibling donor is available.

- Initial partial remission AML (<20% blasts in the bone marrow).

- AML that is refractory to two cycles of induction therapy.

- Second or greater remission AML

- Myelodysplastic/Myeloproliferative Disease

- Juvenile Myelomonocytic Leukemia (JMML)

- Myelosplastic syndrome and/or pre-leukemia at any stage

- Lymphoma

- Relapsed lymphoma with residual disease that appears to be chemo-sensitive
and non-bulky (<5 cm at largest diameter)

- Venous Access: Three lumens of central vascular access will be required for all
patients entered on protocol due to the need for a dedicated line for continuous
infusion cyclosporine.

- Informed Consent: The patient and/or the patient's legally authorized guardian must
acknowledge in writing that consent to become a study subject has been obtained in
accordance with the institutional policies approved by the U.S. Department of Health
and Human Services.

- Patient organ function requirements:

- Adequate renal function: Serum Creatinine <~1.5 x normal, or Creatinine
clearance of 70 mL/min/1.73 mE2 or an equivalent GFR as determined by the
institutional normal range

- Adequate liver function: Total bilirubin <1.5 x normal; and SGOT (AST) or SGPT
(ALT) <~2.5 x normal

- Adequate cardiac function: Shortening fraction of >/=27% by echocardiogram

- Adequate pulmonary function: FEV1/FVC >/=60% by pulmonary function test; for
children who are uncooperative, no evidence of dysnpea at rest, or exercise
intolerance, and must have a pulse oximetry >94% in room air

- Performance status: Lansky for children /= 60; Karnofsky status for
those > 16 years of age >/= 70

- Effective Contraceptive Use: Women of childbearing potential and sexually active
males should use effective contraception while on study.

Exclusion Criteria:

- Patients who are pregnant or lactating

- Inability to find a suitable donor for the patient

- Patient is HIV-positive

- Patient has active Hepatitis B

- Disease progression or relapse prior to HPC infusion