Donor Stem Cell Transplant in Treating Patients With Hematologic Cancer, Metastatic Kidney Cancer, or Aplastic Anemia

DISEASE CHARACTERISTICS:

• Diagnosis of 1 of the following:

  • Aplastic anemia not responsive to immunosuppressive therapy
  • Metastatic renal cell carcinoma

  • Hematologic malignancy, including any of the following:

    • Acute myeloid leukemia (AML)* not curable with chemotherapy and meeting any of the following criteria:

      • AML with high-risk cytogenetic abnormalities (e.g., -7, -7q, -5, -5q, complex, Philadelphia chromosome-positive [Ph+])
      • AML evolved from prior myelodysplasia
      • AML secondary to prior chemotherapy
      • Failed to achieve remission
      • In second or subsequent remission NOTE: *Marrow blasts < 10%- can be achieved by chemotherapy

    • Myelodysplasia* with any of the following high-risk features:

      • Adverse cytogenetics (-7, 7q, -5, -5q, complex)
      • Excess blasts
      • Prior conversion to AML
      • Severe cytopenias with absolute neutrophil count < 500/mm^3 or platelet count < 20,000/mm^3 NOTE: *Marrow blasts < 10%- can be achieved by chemotherapy

    • Acute lymphoblastic leukemia (ALL)* not curable with chemotherapy and meeting any of the following criteria:

      • High-risk cytogenetics (Ph+, 11q23 abnormalities, monosomy 7)
      • More than 1 induction course required to achieve remission
      • Failed to enter remission
      • In second or subsequent remission NOTE: *Marrow blasts < 10 %

    • Chronic lymphocytic leukemia (CLL) with high-risk features, including any of the following:

      • Refractory to initial or subsequent therapy
      • Progression after initial response to therapy
      • Prolymphocytic morphology

    • Follicular lymphoma with any of the following high-risk features:

      • Refractory to initial or subsequent therapy
      • Progression after response to initial therapy
      • Has ≥ 3 International Prognostic Index (IPI) risk factors

    • Multiple myeloma

      • Stage II-III disease confirmed at diagnosis or after initial progression

    • Other lymphoma that has failed to respond to primary therapy, progressed, or recurred after prior therapy, including any of the following:

      • Diffuse large cell lymphoma
      • Mantle cell lymphoma
      • Hodgkin's lymphoma

    • Myeloproliferative disease with evidence of disease acceleration, including any of the following:

      • Myelofibrosis
      • Polycythemia vera
      • Essential thrombocythemia
    • Chronic myeloid leukemia (CML) that failed to be controlled by imatinib mesylate
• Disease must be stable or responding to therapy

• No rapid progression of malignant disease

  • Expected time to disease progression > 12 weeks
• Not eligible for autologous stem cell transplantation

• Matched unrelated donor available

  • 9/10 HLA matched, including HLA-A, -B, -C, -DR, and -DQ

PATIENT CHARACTERISTICS:

• Creatinine < 2.0 mg/dL
• Creatinine clearance > 40 mL/min

• Bilirubin < 3 mg/dL

  • Elevated total bilirubin due to Gilbert's disease allowed if direct bilirubin is normal
• AST < 4 times upper limit of normal
• Hepatitis C or B allowed provided bilirubin and AST are normal
• Cardiac ejection fraction > 30%
• DLCO > 40% of predicted
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No uncontrolled active infection requiring ongoing antibiotic treatment
• No poor performance status
• No poor organ function

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• Prior stem cell or bone marrow transplantation allowed