Stem Cell Transplant in Treating Patients With Hematological Cancer or Other Disorders

DISEASE CHARACTERISTICS:

• Diagnosis of any of the following hematological cancers with a poor prognosis:

  • Acute myeloid leukemia meeting 1 of the following criteria:

    • Third complete remission (CR3) or beyond
    • CR2 after an early bone marrow relapse (< 24 months)
    • Refractory disease after ≥ 2 chemotherapy courses of induction therapy

  • Acute lymphoblastic leukemia meeting 1 of the following criteria:

    • CR3 after ≥ 1 bone marrow relapse
    • CR2 after early bone marrow relapse (currently or within 6 months after stopping maintenance therapy)

  • Chronic myelogenous leukemia meeting the following criteria:

    • Accelerated phase
    • Second chronic phase
    • No other treatment options

  • Multiple myeloma meeting the following criteria:

    • Failed conventional therapy (including autologous hematopoietic stem cell transplantation)
    • No other treatment alternatives

  • Chronic lymphocytic leukemia meeting the following criteria:

    • Failed conventional therapy
    • No other treatment alternatives

  • Hodgkin lymphoma meeting the following criteria:

    • Failed conventional therapy
    • No other treatment alternatives

  • Non-Hodgkin lymphoma meeting the following criteria:

    • Failed conventional therapy
    • No other treatment alternatives
• Not eligible for standard myeloablative allograft due to increased toxicity

• Healthy related donor available and meeting the following criteria:

  • Brother, sister, father, mother, cousin, uncle, or aunt

  • At least an identical HLA haplotype

    • Identical genotype on 1 haplotype (in terms of HLA-A, B, C, and DR)
    • Different on ≤ 4 alleles on the other haplotype
• No HLA-identical intra- or extra-familial donor cord blood available within the next 3 months

PATIENT CHARACTERISTICS:

• Karnofsky performance status 70-100%
• Not pregnant or nursing
• Fertile patients must use effective contraception

• No contraindication to allogeneic transplantation, including any of the following:

  • Cardiac systolic ejection fraction < 40%
  • DLCO level limiting use of fludarabine
  • Creatinine clearance < 30 mL/min
  • Transaminases and/or bilirubin > 3 times upper limit of normal (unless due to Gilbert disease or cancer)
  • HIV seropositivity
  • Human T-cell lymphotrophic virus type 1 seropositivity
  • Uncontrolled bacterial, viral, or fungal infection
• No contraindication to any of the study drugs
• No prior or concurrent psychiatric illness
• No other cancer in the past 5 years except for basal cell skin cancer or carcinoma in situ of the cervix
• No concurrent serious, uncontrolled condition
• No patients deprived of liberty or subject to legal protection

PRIOR CONCURRENT THERAPY:

• No participation in a study of allografts in the past month