Fludarabine, Cyclophosphamide, and Total-Body Irradiation Followed by Cyclosporine and Mycophenolate Mofetil in Treating Patients Who Are Undergoing a Donor Umbilical Cord Blood Transplant for Hematologic Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Diagnosis of 1 of the following hematologic malignancies:
• * Acute myeloid leukemia (AML) with or without history of myelodysplastic syndromes, meeting 1 of the following criteria:
• * In first complete remission (CR-1) with unfavorable cytogenetics and/or achieved CR-1 after ≥ 1 course of induction therapy
• * Secondary or treatment-related AML
• * In second or further complete remission
• * Relapsed with ≤ 20% blasts in the bone marrow AND no circulating blasts
• * Acute lymphoblastic leukemia (ALL), meeting 1 of the following criteria:
• * In CR-1 with unfavorable cytogenetics or elevated WBC at presentation OR failed to achieve CR-1 after ≥ 4 weeks of induction therapy
• * In second or further complete remission
• * Relapsed with ≤ 20% blasts in the bone marrow AND no circulating blasts
• * Other acute leukemic variants allowed at the discretion of the principal investigator
• * Chronic myelogenous leukemia (CML), meeting 1 of the following criteria:
• * In first chronic phase AND refractory to or unable to tolerate imatinib mesylate
• * In second or further chronic phase
• * In first or second accelerated phase
• * Myelodysplastic syndromes with intermediate 2- or high-risk International Prognosis Scoring System (IPSS) score, including any of the following:
• * Refractory anemia
• * Refractory anemia with excess blasts
• * Chronic myelomonocytic leukemia
• * Myeloproliferative disorders with poor prognosis, including any of the following:
• * Myelofibrosis with myeloid metaplasia
• * No ≥ grade 3 myelofibrosis
• * Atypical CML
• * Juvenile myelomonocytic leukemia
• * Other clonal hemopathies with an accepted poor prognosis
• * Multiple myeloma with chromosome 13 abnormalities and/or progression after prior autologous bone marrow transplantation (BMT)
• * Chronic lymphocytic leukemia, meeting 1 of the following criteria:
• * Primary refractory OR relapsed and refractory disease (less than partial remission)
• * Relapsed twice on or after prior chemotherapy
• * Lymphoma, meeting both of the following criteria:
• * Hodgkin's or non-Hodgkin's lymphoma in \> CR-1 OR failed primary induction
• * Chemosensitive disease, defined as \> 50% reduction in mass size after the most recent chemotherapy
• Must meet ≥ 1 of the following criteria:
• * Over 45 years of age
• * Has undergone prior autologous or allogeneic BMT
• * Charlson\^ comorbidity score ≥ 2
• Must have a high degree of tumor control (salvage therapy allowed)
• At high risk for treatment-related mortality with a myeloablative conditioning regimen
• No massive splenomegaly
• * Patients may become eligible after splenectomy or radiotherapy to the spleen
• No 5/6 or 6/6 HLA-matched related donor available
• No well-matched (i.e., ≥ 9/10 HLA match by high-resolution typing) unrelated donor available
• PATIENT CHARACTERISTICS:
• Performance status
• Not specified
• Life expectancy
• Not specified
• Hematopoietic
• See Disease Characteristics
• Hepatic
• Bilirubin ≤ 2 times upper limit of normal (ULN)
• Transaminases ≤ 4 times ULN (unless due to underlying disease)
• Renal
• Creatinine clearance ≥ 50 mL/min
• Cardiovascular
• Ejection fraction ≥ 30%
• Pulmonary
• DCLO ≥ 35%
• Other
• Negative pregnancy test
• No uncontrolled viral, bacterial, or fungal infection
• HIV negative
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• See Disease Characteristics
• Chemotherapy
• See Disease Characteristics
• Radiotherapy
• See Disease Characteristics
• Other
• At least 3 months since prior immunosuppressive therapy
• At least 10 days since prior salvage therapy for patients not in at least morphologic or radiologic complete remission