Pasireotide in Prevention of GI Toxicity

Inclusion Criteria: * 18 years of age or older at the time of study enrollment. * Histologically confirmed diagnosis for which an allogeneic transplant is utilized. * Plan to receive an allogeneic transplant from a 4-6/6 single or dual umbilical cord blood graft, or a 7-8/8 HLA-matched sibling or unrelated donor (High resolution HLA-A, B, C, DRB1). * Meet standard criteria as defined by the institution for a myeloablative allogeneic stem cell transplantation, with myeloablative defined as using conditioning regimens containing: * TBI ≥ 1200 cGy, or * Busulfan ≥ 12.8mg/kg * Patient must have given written informed consent according to FDA guidelines. * Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures. Exclusion Criteria: * Female patients who are pregnant or lactating, or are of childbearing potential (FCBP, defined as all women physiologically capable of becoming pregnant) and not practicing an effective method of contraception/birth control * FCBP must have a current negative serum pregnancy test prior to transplant per institutional practice. * Use of an investigational drug within 1 month prior to dosing. Concurrent enrollment on other clinical research studies that contain an interventional therapy is not permitted while subjects are receiving pasireotide or within 5 half-lives of finishing pasireotide. However, subjects may concurrently enroll in non-interventional studies (e.g. biobanking, mobile health tracking). * Active CNS disease (related to primary malignancy) at the time of enrollment. * Patients with existing grade 2 toxicities, except as approved by the investigator. * Any of the following diseases or conditions: Cardiac: * History of unexplained syncope or family history of idiopathic sudden death. * Sustained or clinically significant cardiac arrhythmias. * Risk factors for Torsades de Pointes such as: * Uncontrolled hypokalemia * Uncontrolled hypomagnesemia or hypermagnesemia * Cardiac failure (New York Heart Association Class II or higher) * Clinically significant/symptomatic bradycardia (HR \< 50), or high-grade AV block. * Known diagnosis of QT prolongation (QTc ≥ 470) or family history of long QT syndrome * Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes, or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure. * Concomitant medications known to prolong the QT interval during the same time as pasireotide is to be administered (unless approved by PI and QTc \< 470; standard transplant medications that are known to prolong the QT (e.g. azoles, ondansetron, etc.) are permitted but caution is advised and patients should be closely monitored). Endocrine: * Uncontrolled diabetes at the time of cytoreduction. All patients with diabetes must be optimized on their diabetes regimen prior to initiating pasireotide. • If a patient is diabetic: uncontrolled diabetes as defined by HbA1c \> 8 per cent despite adequate therapy * Patients who are not biochemically euthyroid. Patients with known history of hypothyroidism are eligible if they are on adequate and stable replacement thyroid hormone therapy for at least 3 months. * Known diagnosis of hypocortisolism * Known diagnosis of pituitary hormone deficiency. * Known hypersensitivity to somatostatin analogs or any component of the pasireotide LAR or s.c. formulations. Infectious: * Uncontrolled (not being treated) infections at the time of cytoreduction. * A positive HIV test result (ELISA and Western blot) or history of known HIV. An HIV test will not be required; however, previous medical history will be reviewed. Gastrointestinal: * Moderately impaired hepatic function (Child-Pugh B) or severe hepatic impairment (Child-Pugh C) * Known gallbladder or bile duct disease, symptomatic cholelithiasis, acute or chronic pancreatitis. * Known malabsorption syndrome, short bowel or chologenic diarrhea not controlled by specific therapeutic means. Hematologic: * Abnormal coagulation (PT or aPTT \> 30% above normal limits). * Continuous anticoagulation therapy. Patients who were on anticoagulant therapy must complete a washout period of at least 10 days and have confirmed normal coagulation parameters before study inclusion. Miscellaneous: * Major surgery/surgical therapy for any cause within 1 month prior to pasireotide administration. Patients should have recovered and have a good clinical condition before entering the study. * Any co-morbid condition which, in the view of the Principal Investigator, renders the patient at high risk from treatment complications. Patients with a history of non-compliance to medical regimens or who are considered potentially unreliable or will not be able to complete the entire study.