Total-Body Irradiation, Fludarabine, and Peripheral Stem Cell Transplantation in Treating Patients With Hematologic Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of one of the following hematologic malignancies:
• •* Chronic myelogenous leukemia (CML)
• •* First or second chronic phase
• •* Accelerated phase
• •* Acute myelogenous leukemia (AML)
• •* At least second remission
• •* First remission allowed if poor-risk features are present (complex chromosome karyotype, abnormalities of chromosomes, especially 5 or 7, 12p-, +13, +8, t\[9:11\])
• •* Myelodysplastic syndromes (MDS)
• •* Intermediate- or high-risk disease by the prognostic scoring system
• •* Multiple myeloma (MM)
• •* Hodgkin's lymphoma
• •* Second or greater relapse
• •* First relapse allowed if disease-free interval is less than 1 year
• •* Ineligible for autologous transplantation
• •* Non-Hodgkin's lymphoma (NHL)
• •* Grade III follicular large cell (relapsed after one course of prior chemotherapy)
• •* Diffuse large cell (relapsed after one course of prior chemotherapy)
• •* Mantle cell
• •* Chronic lymphocytic leukemia (CLL)
• •* Relapsed after at least 1 course of prior therapy
• •Must have 6 out of 6 HLA A-, B-, and DR- identical sibling donor
• •PATIENT CHARACTERISTICS:
• •Age
• •18 to 75 for patients with MM
• •50 to 75 for patients with CML, AML, MDS, Hodgkin's lymphoma, NHL, or CLL
• •18 to 49 for patients with CML, AML, MDS, Hodgkin's lymphoma, NHL, or CLL who are considered eligible for an allogeneic bone marrow transplantation (BMT) but do not meet institutional criteria for a standard allogeneic BMT
• •Performance status
• •Zubrod 0-2
• •Life expectancy
• •At least 6 months
• •Hematopoietic
• •Not specified
• •Hepatic
• •Bilirubin no greater than 3 mg/dL
• •Renal
• •Creatinine no greater than 2 mg/dL
• •Cardiovascular
• •LVEF at least 40% by MUGA or echocardiogram
• •Pulmonary
• •DLCO at least 50% of predicted
• •Other
• •HIV negative
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •No recent history of drug or alcohol abuse
• •No other prior malignancy except basal cell skin cancer
• •No uncontrolled bacterial, viral, fungal, or parasitic infections
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •Prior autologous transplantation allowed if disease progression occurred
• •No prior or concurrent tandem autologous transplantation followed by non-myeloablative-allograft protocol
• •Chemotherapy
• •See Disease Characteristics
• •Endocrine therapy
• •Not specified
• •Radiotherapy
• •Not specified
• •Surgery
• •Not specified