Low-Dose or High-Dose Conditioning Followed by Peripheral Blood Stem Cell Transplant in Treating Patients With Myelodysplastic Syndrome or Acute Myelogenous Leukemia

Exclusion Criteria

• •HIV seropositivity
• •Fungal infections with radiographic progression after appropriate therapy for greater than one month
• •Organ dysfunction
• •Symptomatic coronary artery disease or ejection fraction \< 35%
• •DLCO \< 65%, FEV1 \< 65% or receiving supplementary continuous oxygen
• •Liver function abnormalities: Patients with clinical or laboratory evidence of liver disease will be evaluated for the cause of liver disease, its clinical severity in terms of liver function, histology, and the degree of portal hypertension; patients with fulminant liver failure, cirrhosis with evidence of portal hypertension or bridging fibrosis, alcoholic hepatitis, esophageal varices, a history of bleeding esophageal varices, hepatic encephalopathy, uncorrectable hepatic synthetic dysfunction evidenced 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 will be excluded
• •Karnofsky Performance Score \< 70
• •Lansky-Play Performance Score \< 70 for pediatric patients
• •Life expectancy severely limited (\< 2 years) by disease other than MDS/AML
• •Fertile men and women unwilling to use contraceptive techniques during and for 12 months following treatment
• •Patients with active non-hematological malignancies except:
• •A) Patients with follicular or low grade lymphoma will be eligible as long as they have not and do not require active treatment for control of their disease
• •B) Patients with localized non-melanoma skin malignancies
• •Patients with poorly controlled hypertension who are unable to have blood pressure stabilized below 150/90 mm Hg on standard medication
• •Females who are pregnant or breastfeeding
• •Patients with systemic, uncontrolled infections
• •Active CNS disease as identified by positive CSF cytospin
• •DONOR: Identical twin
• •DONOR: Age \< 12 years
• •DONOR: Pregnancy
• •DONOR: HIV seropositivity
• •DONOR: Inability to achieve adequate venous access
• •DONOR: Known adverse reaction to G-CSF