Fludarabine and Radiation Therapy in Treating Patients Who Are Undergoing Donor Stem Cell Transplant for Chronic Phase or Accelerated Phase Chronic Myelogenous Leukemia

Exclusion Criteria

• •Failed OR suboptimal response to prior imatinib mesylate, as defined by 1 of the following:
• •* Absence of complete hematologic response after \> 3 months of treatment with imatinib mesylate
• •* Absence of cytogenetic response, as defined by 1 of the following:
• •* Absence of any cytogenetic response (\< 95% Ph+ or BCR/ABL+ cells by cytogenetic or FISH analysis, respectively) after 6 months of treatment with imatinib mesylate
• •* Absence of major cytogenetic response (\< 35% Ph+ or BCR/ABL+ cells by cytogenetic or FISH analysis, respectively) after 1 year of treatment with imatinib mesylate
• •* Absence of complete cytogenetic response (no Ph+ cells by cytogenetic analysis OR BCR/ABL+ cells within normal limits by FISH analysis) after 18 months of treatment with imatinib mesylate
• •* Hematologic evidence of disease progression
• •* Cytogenetic evidence of disease progression
• •* Increase in Ph+ cells or BCR/ABL+ cells by \> 20% with at least 1 month between sequential testing
• •* Molecular evidence of disease progression
• •* More than 10-fold increase in BCR/ABL mRNA levels by quantitative polymerase chain reaction (Q-PCR) with at least 1 month between 2 sequential tests
• •* Experienced adverse events during treatment with imatinib mesylate that precluded further administration of the drug
• •No CNS disease refractory to intrathecal chemotherapy
• •HLA identical related donor available
• •* Phenotypically matched at HLA-A, -B, -C, DRQ1, and DBQ1
• •No presence of circulating leukemic blasts by standard pathology
• •PATIENT CHARACTERISTICS:
• •Age
• •Any age
• •Performance status
• •Karnofsky 70-100% OR
• •Lansky 70-100%
• •Life expectancy
• •Not specified
• •Hematopoietic
• •See Disease Characteristics
• •Hepatic
• •No fulminant liver failure
• •No cirrhosis of the liver with evidence of portal hypertension or bridging fibrosis
• •No alcoholic hepatitis
• •No esophageal varices
• •No history of bleeding esophageal varices
• •No hepatic encephalopathy
• •No uncorrectable hepatic synthetic dysfunction evidenced by prolongation of PT
• •No ascites related to portal hypertension
• •No bacterial or fungal liver abscess
• •No biliary obstruction
• •No chronic viral hepatitis AND bilirubin \> 3 mg/dL
• •No symptomatic biliary disease
• •Renal
• •Renal failure allowed
• •Cardiovascular
• •No symptomatic coronary artery disease
• •Ejection fraction ≥ 35%
• •No other cardiac failure requiring therapy
• •No poorly controlled hypertension (blood pressure ≥ 150/90 mm Hg) on standard medication
• •Pulmonary
• •DLCO ≥ 30%
• •Total lung capacity ≥ 30%
• •FEV\_1 ≥ 30%
• •No requirement for continuous supplementary oxygen
• •No fungal pneumonia with radiological progression after treatment with amphotericin or mold-active azoles for \> 1 month
• •Other
• •Not pregnant or nursing
• •Fertile patients must use effective barrier contraception during and for 12 months after completion of study treatment
• •HIV negative
• •No other disease that severely limits life expectancy
• •No other active malignancy except localized nonmelanoma skin cancer
• •No nonhematologic malignancy within the past 5 years that is currently in complete remission and has a \> 20% risk of disease recurrence except for nonmelanoma skin cancer
• •No systemic uncontrolled infection
• •No active bacterial or fungal infection unresponsive to medical therapy
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •See Disease Characteristics
• •Chemotherapy
• •See Disease Characteristics
• •Endocrine therapy
• •Not specified
• •Radiotherapy
• •Not specified
• •Surgery
• •Not specified
• •Other
• •At least 48 hours since prior imatinib mesylate