Fludarabine and Total-Body Irradiation Followed By Donor Stem Cell Transplant and Cyclosporine and Mycophenolate Mofetil in Treating HIV-Positive Patients With or Without Cancer

Inclusion Criteria:

• Patients with hematologic malignancy, lymphoma or other HIV-associated malignancy are eligible provided these criteria are met:

  • The malignancy is in complete remission or very good partial remission, defined as a significant reduction of disease with therapy and no evidence for continued tumor growth in the case of lymphoma or solid tumors
  • Highly active antiretroviral therapy (HAART) is initiated within one month of hematopoietic cell transplant
  • Viral load has decreased by >= 1.5 logs or viral load < 5000 copies/ml plasma on HAART therapy
  • CD4 count is allowed to be > 100 cells/ul

• HIV infected patients without malignancy who have failed HAART are eligible provided that these criteria are met:

  • They have been treated with more than one regimen of HAART for a total of at least 6 months duration
  • The viral load is < 50 copies/ml plasma
  • The CD4 count < 100 cells/ul

• DONOR: Human leukocyte antigen (HLA) genotypically/phenotypically identical donor; if more than one HLA-identical sibling is available, priority will be given to donors matched for cytomegalovirus (CMV) status, ABO titer, and sex

  • Peripheral blood stem cells will be collected from donors greater than 12 years of age
  • Bone marrow will be collected from donors less than 12 years of age

• DONOR: HLA phenotypically identical unrelated donor; match grades allowed:

  • Match grade 1: Matched at allele level for HLA-A, B, C, DRB1, and DQB1
  • Match grade 2.1: Single allele disparity for HLA-A, B, C, DRB1, and DQB1

Exclusion Criteria:

• Positive serology for toxoplasma gondii on treatment or with evidence of active infection
• Patients with other disease or organ dysfunction that would limit survival to less than 30 days
• Patients with medical history of noncompliance with HAART or medical therapy
• DONOR: Donors for whom medical or psychologic reasons would make donor procedure intolerable
• DONOR: Marrow donors who have increased anesthetic risk
• DONOR: Donors who are HIV positive
• DONOR: Age > 75 years