Addition of Etanercept and Extracorporeal Photopheresis (ECP) to Standard Graft-Versus-Host Disease (GVHD) Prophylaxis in Stem Cell Transplant

reduced intensity, matched unrelated donor stem cell transplant

"Tacrolimus(or cyclosporine when necessary)~Tacrolimus will begin on day -3, IV or oral.~Target trough level for tacrolimus is 8-12 ng/ml.~In the absence of GVHD, tacrolimus tapering will begin on day +56 post transplant"

Mycophenolate will begin on day 0 at 10 mg/kg/dose (up to 1 gram per dose) every 8 hours orally or intravenously and will continue until day 28.

Etanercept will be given at a dose 0.4 mg/kg (actual weight) up to a maximum dose of 25 mg, subcutaneously, twice weekly from day 0 to day 56 (16 doses)

"Methoxsalen (UVADEX) treatments by Extracorporeal photopheresis (ECP) will be started day +28 post transplant and given weekly.~On day +70 post transplant ECP frequency will be given every other week.~On day +100 post transplant ECP will be given monthly until day +180 and stopped."