Alemtuzumab, Fludarabine, and Busulfan Followed By Donor Stem Cell Transplant in Treating Young Patients With Hematologic Disorders

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of 1 of the following hematologic conditions:
• •* Aplastic anemia with marrow aplasia, meeting all of the following criteria:
• •* Absolute neutrophil count \< 500/mm\^3
• •* Platelet and/or red cell transfusion dependent
• •* Chronic aplastic anemia, meeting all of the following criteria:
• •* Transfusion dependent
• •* Unresponsive to immunosuppressive therapy
• •* Alternative matched unrelated donor has been identified
• •* Congenital marrow failure syndrome, including any of the following (with closely matched related or unrelated donor):
• •* Primary red cell aplasia (Diamond-Blackfan syndrome)
• •* Congenital neutropenia (Kostmann's syndrome)
• •* Amegakaryocytic thrombocytopenia
• •* Congenital dyserythropoietic anemias
• •* Other severe acquired cytopenias in which a transplantation using a combined busulfan/cyclophosphamide conditioning regimen is indicated
• •* Hemoglobinopathy (with closely matched related or unrelated donor)
• •* β-thalassemia major
• •* Sickle cell anemia
• •* Hemoglobin E/β-thalassemia
• •* Severe immunodeficiency disease
• •* Chediak-Higashi disease
• •* Wiskott-Aldrich syndrome
• •* Combined immunodeficiency disease (Nezelof's)
• •* Hyper immunoglobulin M (IgM) syndrome
• •* Bare lymphocyte syndrome
• •* Chronic granulomatous disease
• •* Familial erythrohemophagocytic lymphohistiocytosis
• •* Other stem cell defects (e.g., osteopetrosis)
• •* Severe immune dysregulation/autoimmune disorders
• •* Achieved a transient response to prior immunosuppressive therapy
• •* Chronic myelogenous leukemia
• •* Disease in first chronic phase
• •* Acute myeloid leukemia
• •* Disease in first remission
• •* Myelodysplastic syndromes
• •* Inborn errors of metabolism
• •* Histiocytosis
• •No severe combined immunodeficiency disease
• •Matched related or unrelated donor available by high resolution DNA typing
• •* Related donor, meeting both of the following criteria:
• •* Matched at both human leukocyte antigen (HLA)-Drβ1 alleles
• •* No more than 1 mismatch at the 4 HLA-A and -B alleles
• •* Unrelated donor, meeting 1 of the following criteria:
• •* Marrow matched at both HLA-Drβ1 alleles AND no more than 1 mismatch at the 4 HLA-A and -B alleles
• •* Umbilical cord blood matched at 5/6 HLA-A, -B, and -DRβ1 alleles with at least 1 -DRβ1 match AND there are ≥ 3x10\^5 CD34+ (Cluster of differentiation 34-positive) cells per kg body weight of recipient available at the time of cryopreservation
• •PATIENT CHARACTERISTICS:
• •Cardiac ejection fraction ≥ 27%
• •Creatinine clearance ≥ 50 mL/min by 24-hour urine collection or glomerular filtration rate
• •DLCO (diffusion capacity of lung for carbon monoxide) ≥ 50% of predicted (corrected for anemia/lung volume)
• •PRIOR CONCURRENT THERAPY:
• •No prior transplantation for leukemia from which patient remains engrafted and alemtuzumab is not needed as part of the conditioning regimen