Bone Marrow Transplantation in Treating Patients With Hematologic Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically proven hematologic malignancy of 1 of the following types:
• * Chronic myelogenous leukemia (CML) in chronic, accelerated, or blast\* phase
• * Acute leukemia with high-risk features at diagnosis such as:
• * Philadelphia chromosome-positive acute lymphocytic leukemia\*\*
• * Acute myeloid leukemia with high-risk cytogenetics such as inv (3), t(3;3) del(5q), -5, del(7q), -7, +8, +11, abnormal 12p, del(20q), -20, or complex abnormalities\*\*
• * Acute leukemia with failure after one course of induction chemotherapy
• * Acute leukemia in first relapse\* or second remission
• * High-risk lymphoblastic lymphoma in first remission
• * Non-Hodgkin's lymphoma, Hodgkin's disease, or other malignant lymphoproliferative disease after first remission, if an autologous transplantation is not indicated
• * Myelodysplastic or myeloproliferative syndromes ineligible for Protocol FHCRC-179 NOTE: \* For patients with acute leukemia in relapse or CML in blast crisis, the search for an unrelated donor begins only if: High probability that the patient's medical condition will remain stable for the 3 to 6-month period needed to find a donorAn attempt at remission induction has been undertaken Referring physician and patient accept possibility that search for donor will be canceled if patient's condition worsens
• NOTE: \*\* For newly diagnosed patients with high-risk acute leukemia, early referral is encouraged so that an unrelated donor search may begin immediately
• Availability of an unrelated donor with:
• * 1 HLA-A or B non-cross-reactive group (non-CREG) mismatch (except in CML in chronic phase or myelodysplastic syndrome) OR
• * 1 HLA-A or B CREG mismatch OR
• * An HLA-A, B, and C match with an HLA-DRB1 or DQB1 mismatch (no double mismatch) if 1 of the above 2 donor types unavailable
• * No more than 1 HLA-A, B, and C mismatch
• No availability of an HLA-identical sibling or haploidentical relative incompatible for 0 or 1 HLA-A or B locus of the nonshared haplotypes
• * For patients with diagnosis other than CML in chronic phase, 1 HLA-DR locus-incompatible related donor has priority over an HLA compatible or class IA or B CREG locus antigen-incompatible unrelated donor
• No severe aplastic anemia
• No leukoencephalopathy
• PATIENT CHARACTERISTICS:
• Age:
• Under 51
• Eligible for transplantation until age 52 if the donor is identified prior to patient's 51st birthday
• Performance status:
• Not specified
• Life expectancy:
• Not specified
• Hematopoietic:
• See Disease Characteristics
• Hepatic:
• No severe hepatic disease, including acute hepatitis
• Renal:
• Creatinine less than 2 times normal
• Cardiovascular:
• No cardiac insufficiency requiring treatment
• No symptomatic coronary artery disease
• Pulmonary:
• No severe hypoxemia (i.e., PO2 less than 70 mm Hg) with decreased DLCO (i.e., DLCO less than 70% predicted) OR
• No mild hypoxemia (i.e., PO2 less than 80 mm Hg) with severely decreased DLCO (i.e., DLCO less than 60% predicted)
• No pulmonary fibrosis
• Other:
• No other nonmalignant disease that would severely limit life expectancy
• HIV negative
• No contraindication to total body irradiation (TBI)
• Patients excluded from this study because of contraindication to TBI may be treated on protocol FHCRC-739
• PRIOR CONCURRENT THERAPY:
• Biologic therapy:
• See Disease Characteristics
• Chemotherapy:
• See Disease Characteristics
• Endocrine therapy:
• Not specified
• Radiotherapy:
• No prior radiotherapy greater than 3,000 cGy to whole brain
• At least 6 months since prior involved-field radiotherapy greater than 1,500 cGy to chest or abdomen
• Surgery:
• Not specified