Identify Barriers to Allogeneic Hematopoietic Stem Cell Transplantation in Patients With Newly Diagnosed and Relapsed Acute Leukemia

Inclusion Criteria13

• Patients with newly diagnosed or relapsed acute leukemia. Patients undergoing reinduction due to primary induction failure are also eligible. Patients with acute leukemia will be enrolled to Arm A
• Patients with diagnosis of MDS, MPN and MDS/MPN overlap who meet any of the following criteria (based on NCCN guidelines):
• Clinically significant cytopenia of at least 2 cell lines affected; Hgb\<10,
• Platelet\<100,000, absolute neutrophil count\<1000
• Bone marrow blasts \>5% and any level of circulating blasts
• Evidence of disease progression or no response to hypomethylating agents/immunosuppressive treatment or a clinical trial.
• IPSS Intermediate-1 and higher
• IPSS-R intermediate and higher
• All cases of therapy related MDS with excess blasts
• In patients with Myelofibrosis: Low risk disease by DIPSS with either refractory, transfusion dependent anemia, circulating blasts cells greater than 2%; or adverse cytogenetics and any patient with DIPSS-intermidiate 1 and higher.
• Patients with acute leukemia or MDS/MPN who relapse after first allografts. Patients with post-transplant relapse will be enrolled to Arm C.
• Patients 18 years of age or older and 80 years of age or younger
• For the purposes of this protocol "relapse" is defined as re-emergence of the initial abnormal myeloid blast population (or blast equivalent) comprising 5% or more of marrow WBC or any amount prompting a therapeutic intervention targeting relapsed disease, including, but not limited to withdrawal of immunosuppression, targeted therapies, chemotherapy, etc.