Donor Lymphocyte Infusion in Treating Patients With Persistent, Relapsed, or Progressing Cancer After Donor Hematopoietic Cell Transplant

Inclusion Criteria:

• Only patients having received a preceding nonmyeloablative allogeneic transplantationwith fludarabine/2 Gy total-body irradiation (TBI) - 4 Gy TBI or 2 Gy TBI - 4 Gy TBIconditioning from either a related or unrelated donor are eligible for this protocol

• Patients with persistent, relapsed or progressing malignancy after nonmyeloablativeallogeneic transplantation; persistent disease will be defined as a failure to achievea response as compared to baseline

• Patients with rapidly progressing malignancies (acute myeloid leukemia [AML], acutelymphocytic leukemia [ALL], blastic phase chronic myelogenous leukemia [CML-BC]intermediate-high-grade non-Hodgkin lymphoma [NHL], Hodgkin's lymphoma or aggressivemultiple myeloma [MM]) should receive salvage chemotherapy or radiation before DLIaccording to the recommendation made in this protocol; any form of salvagechemotherapy should be discontinued no less than 3 weeks before DLI; therapy withGleevec or interferon (IFN)-alpha should be discontinued prior to DLI; after salvagechemotherapy restaging is performed, patients with progressive disease and patientsnot meeting the inclusion criteria of the study after chemotherapy will be excludedfrom the study; patients are allowed to receive further doses of chemotherapy afterDLI administration if they are scheduled for further DLI; after additional therapy thepatients must be restaged and must again meet inclusion criteria to receive furtherDLI

• Patients must be able to tolerate a taper of systemic steroids to a dosage of lessthan or equal to 0.25 mg/kg/day; all other immunosuppressive therapy must have beendiscontinued for at least two weeks without significant flares in GVHD (i.e., increaseof acute GVHD by one or more grades)

• Patients must have persistent donor cluster of differentiation (CD)3 cells (> 5% donorCD3 cells by a deoxyribonucleic acid [DNA]-based assay that compares the profile ofamplified fragment length polymorphisms [ampFLP] [or fluorescent in situ hybridization (FISH) studies or variable number tandem repeat (VNTR)])

• DONOR: Alternatively to a fresh unmodified leukapheresis product, previously collectedcryopreserved peripheral blood stem cells (PBSC) after mobilization with granulocytecolony-stimulating factor (G-CSF) or cryopreserved unmodified leukapheresis productfrom the original donor can be used; if cryopreserved product is not available, theDLI product must be from the original donor of hematopoietic cell transplantation

• DONOR: Original donor of hematopoietic cell transplantation

• DONOR: Donor must give consent to leukapheresis

• DONOR: Donor must have adequate veins for leukapheresis or agree to placement ofcentral venous catheter (femoral or subclavian)

• DONOR: Donor must be medically fit to undergo the apheresis procedure (institutionalguidelines for apheresis)

Exclusion Criteria:

• Current grade II to IV acute GVHD or extensive chronic GVHD

• Karnofsky score < 50%

• Lansky Play-Performance Score < 40 for pediatric patients

• DONOR: Donors who are not suitable for medical reasons to donate peripheral bloodmononuclear cells (PBMC) by continuous centrifugation according to the criteria of theAmerican Association of Blood Banks (AABB)

• DONOR: Pregnancy

• DONOR: Human immunodeficiency virus (HIV) or human T-lymphotrophic virus (HTLV)infection

• DONOR: Recent immunization may require a delay