Cord blood transplants (CBT) are a standard treatment for adults with blood cancers. MSK has developed a standard ("optimized") practice for cord blood transplant (CBT). This optimized practice includes how patients are evaluated for transplant, the conditioning treatment (standard chemotherapy and total body irradiation therapy) given to prepare the body for transplant, the amount of stem cells transplanted, and how patients are followed during and after transplant.The purpose of this study is to collect information about participant outcomes after CBT following MSK's optimized practice. The researchers will look at outcomes of the CBT treatment such as side effects, disease relapse, GVHD, and immune system recovery after CBT treatment.
Known prior diagnosis of myelodysplasia (MDS) or myeloproliferative disorder (MPD).
Therapy-related AML.
Presence of extramedullary leukemia at diagnosis.
Requirement for 2 or more inductions to achieve CR1.
Diagnosis of myelofibrosis or other malignancy with moderate-severe bone marrow fibrosis.
Patients with persistent with CNS involvement in CSF or CNS disease at time of screening
Prior checkpoint inhibitors/ blockade in the last 12 months.
Two prior stem cell transplants of any kind.
Single group
Conditioning Chemotherapy
DrugConditioning: Cyclophosphamide (CY) 50 mg/kg x1 (day -6), Fludarabine (FLU) 30 mg/m2 x5 (days -6 to -2), Thiotepa (THIO) 5 mg/kg x2 (days -5 \& -4), Total Body Irradiation (TBI) 200 cGy x2 (days -2 \& -1). GVHD prophylaxis: Cyclosporine (CSA) 3 mg/kg q12 hours \& Mycophenolate Mofetil (MMF) 15 mg/kg q8 hours (starting IV day -3).
Cord blood graft
Biological/VaccineThe double-unit CB graft will be infused on day 0 per standard practice.
Overall survival (OS)
Time to neutrophil engraftment
The day of neutrophil recovery is the 1st day of 3 consecutive days of absolute neutrophil count (ANC) at or above 500 after the first post-CBT nadir.
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