Total-Body Irradiation and Fludarabine Phosphate Followed by Donor Peripheral Blood Stem Cell Transplant in Treating Patients With Hematologic Malignancies or Kidney Cancer

* Low grade NHL - with \< 6 month duration of complete remission (CR) between courses of conventional therapy

* Chronic lymphocytic leukemia (CLL) - must have failed two lines of conventional therapy and be refractory to fludarabine

* Hodgkin's disease (HD) - must have received and failed frontline therapy

* Multiple myeloma (MM) - must have received prior chemotherapy; consolidation of chemotherapy by autografting prior to nonmyeloablative HSCT is permitted

* Acute myeloid leukemia (AML) - must have \< 5% marrow blasts at the time of transplant

* Acute lymphoblastic leukemia - must have \< 5% blasts at the time of transplant

* Chronic myelogenous leukemia (CML) - patients will be accepted in chronic phase or accelerated phase; patients who have received prior autografts after high dose therapy or have undergone intensive chemotherapy with PBSC autologous or conventional HSCT for advanced CML may be enrolled provided they are in CR or chronic phase (CP) and have \< 5% marrow blasts at time of transplant

* Myelodysplastic syndromes (MDS)/myeloproliferative disorder (MPD) - only patients with MDS/refractory anemia (RA) or MDS/refractory anemia with ringed sideroblasts (RARS) will be eligible for this protocol; additionally patients with myeloproliferative syndromes (MPS) will be eligible; those patients with MDS or MPS with \> 5% marrow blasts (including those with transformation to AML) must receive cytotoxic chemotherapy and achieve \< 5% marrow blasts at time of transplant

* Renal cell carcinoma - must have evidence of disease not amenable to surgical cure or history of or active metastatic disease by radiological and histologic criteria

DONOR: FHCRC matching allowed will be grade 1.0 to 2.1; unrelated donors who are prospectively:

* Matched for human leukocyte antigen (HLA)-A, B, C, DRB1 and DQB1 by high resolution typing

* Only a single allele disparity will be allowed for HLA-A, B, or C as defined by high resolution typing

DONOR: A positive anti-donor cytotoxic crossmatch is an absolute donor exclusion

DONOR: Patient and donor pairs homozygous at a mismatched allele are considered a two-allele mismatch, i.e., the patient is A\*0101 and the donor is A\*0201, and this type of mismatch is not allowed

DONOR: PBSC only will be permitted as a hematopoietic stem cell (HSC) source on this protocol

Patients with rapidly progressive intermediate or high grade NHL

Renal cell carcinoma patients:

* With expected survival of less than 6 months

* Disease resulting in severely limited performance status (\< 70%)

* Any vertebral instability

* History of brain metastases

Central nervous system (CNS) involvement with disease refractory to intrathecal chemotherapy

Fertile men or women unwilling to use contraceptive techniques during and for 12 months following treatment

Females who are pregnant

Patients with non-hematological tumors except renal cell carcinoma

Fungal infections with radiological progression after receipt of amphotericin B or active triazole for greater than 1 month

Cardiac ejection fraction \< 35%; ejection fraction is required if there is a history of anthracycline exposure or history of cardiac disease

Diffusion capacity of the lung for carbon monoxide (DLCO) \< 40% and/or receiving supplementary continuous oxygen

The FHCRC PI of the study must approve of enrollment of all patients with pulmonary nodules

Patients with clinical or laboratory evidence of liver disease would be evaluated for the cause of liver disease, its clinical severity in terms of liver function, and the degree of portal hypertension; patients will be excluded if they are found to have fulminant liver failure, cirrhosis of the liver with evidence of portal hypertension, alcoholic hepatitis, esophageal varices, a history of bleeding esophageal varices, hepatic encephalopathy, uncorrectable hepatic synthetic dysfunction evinced by prolongation of the prothrombin time, ascites related to portal hypertension, bacterial or fungal liver abscess, biliary obstruction, chronic viral hepatitis with total serum bilirubin \> 3 mg/dL, and symptomatic biliary disease

Karnofsky scores \< 60 (except renal cell carcinoma \[RCC\])

Patients with \> grade II hypertension by common toxicity criteria (CTC)

Human immunodeficiency virus (HIV) positive patients

The addition of cytotoxic agents for "cytoreduction" with the exception of hydroxyurea and imatinib mesylate will not be allowed within two weeks of the initiation of conditioning

DONOR: Marrow donors

DONOR: Donors who are HIV-positive and/or, medical conditions that would result in increased risk for filgrastim (G-CSF) mobilization and harvest of PBSC

What this study is about