Donor Bone Marrow Transplant in Treating Patients With Leukemia, Lymphoma, or Nonmalignant Hematologic Disorders

DISEASE CHARACTERISTICS:

• Histologically confirmed diagnosis of one of the following:

• Acute lymphocytic leukemia (ALL):

• Complete remission (CR) 1 - high risk defined as overt CNS involvement or poor cytogenetics (additions, deletions, translocations, or multiple abnormalities)

• CR2

• Induction failures

• Relapse - patients with at least 10% marrow blasts undergo at least one reinduction attempt

• Acute myelogenous leukemia (AML):

• CR1 - high risk defined as poor cytogenetics (deletions, additions, multiple abnormalities)

• CR2

• Induction failures

• Relapse - patients with at least 10% marrow blasts undergo at least one reinduction attempt

• Chronic myelogenous leukemia (CML):

• Chronic phase (CP) 1

• Accelerated phase/CP2 - patients in blast phase must undergo treatment and achieve a second chronic phase prior to transplant

• Chronic lymphocytic leukemia (CLL):

• Relapse - any stage; must have received no more than 3 prior regimens

• Multiple myeloma:

• At diagnosis - primary refractory

• Relapse (no more than 2) - sensitive disease

• Plasma cell leukemia

• Inability to achieve a complete remission after autologous transplant (no older than 40)

• Myelodysplasia - all subtypes

• Myeloproliferative disorders - patients with poor response to medical therapy or cytogenetic abnormalities

• Severe aplastic anemia (SAA):

• Very SAA - at diagnosis

• SAA - induction therapy

• Donors must be a phenotypic (6 out of 6) match or a one antigen (A or B) mismatch

PATIENT CHARACTERISTICS:

Age:

• 15 to 50

Performance status:

• Karnofsky 80-100%

Life expectancy:

• Not specified

Hematopoietic:

• See Disease Characteristics

Hepatic:

• Bilirubin no greater than 2.0 mg/dL

• SGOT and SGPT no greater than 3 times normal

• PT/PTT normal

Renal:

• Creatinine no greater than 2.0 mg/dL

• Creatinine clearance at least 60 mL/min

Cardiovascular:

• Left ventricular ejection fraction at least 45%

• No myocardial infarction within past 6 months

• No uncontrolled arrhythmias

Pulmonary:

• FEV1 at least 50%

• DLCO at least 50% predicted

Other:

• No active serious infection

• HIV negative

• Not pregnant or nursing

• No uncontrolled diabetes mellitus or thyroid disease

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• See Disease Characteristics

Chemotherapy:

• See Disease Characteristics

Endocrine therapy:

• Not specified

Radiotherapy:

• Not specified

Surgery:

• Not specified