Reduced-Intensity Busulfan and Fludarabine With or Without Antithymocyte Globulin Followed by Donor Stem Cell Transplant in Treating Patients With Hematologic Cancer or Other Disease

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed diagnosis of 1 of the following:
• * Chronic lymphocytic leukemia (CLL), meeting the following criteria:
• * Absolute lymphocyte count \> 5,000/mm³
• * Lymphocytes must appear morphologically mature with \< 55% prolymphocytes
• * Lymphocyte phenotype with expression of CD19 and cluster of differentiation 5 (CD5)
• * Prolymphocytic leukemia (PLL), meeting the following criteria:
• * Absolute lymphocyte count \> 5,000/mm³
• * More than 55% prolymphocytes
• * Morphologically diagnosed
• * Chronic myelogenous leukemia (CML), meeting the following criteria:
• * Diagnosis of CML or similar myeloproliferative disorders based on t(9;22) or related t(9;12) cytogenetic abnormalities AND characterized by elevated white blood cell (WBC) counts in peripheral blood or bone marrow
• * In first chronic phase CML and a candidate for treatment with reduced-dose busulfan
• * Patients with other cytogenetic abnormalities, such as t(9;12), that are associated with an aggressive clinical course are eligible
• * Non-Hodgkin's lymphoma (NHL), meeting the following criteria:
• * Any World Health Organization (WHO) class histologic subtype allowed
• * Core biopsies are acceptable provided they contain adequate tissue for primary diagnosis and immunophenotyping
• * Bone marrow biopsies as sole means of diagnosis are not allowed for follicular lymphoma
• * Hodgkin's lymphoma, meeting the following criteria:
• * Any WHO class histologic subtype allowed
• * Core biopsies are acceptable provided they contain adequate tissue for primary diagnosis and immunophenotyping
• * Multiple myeloma, meeting the following criteria:
• * Active disease requiring treatment (Durie-Salmon stages I, II, or III)
• * Acute myeloid leukemia with documented control, defined as \< 10% bone marrow blasts and no circulating blasts
• * Acute lymphoblastic leukemia, meeting the following criteria:
• * In early first relapse or beyond OR in first complete remission and has 1 of the following high-risk features:
• * t(9;22) or t(4;11)
• * WBC count \> 30,000/mm³ at presentation
• * Non-T-cell phenotype
• * More than 30 years of age
• * Agnogenic myeloid metaplasia/myelofibrosis
• * Patients who are transfusion dependent or who have evolving myelodysplastic or leukemic features or high-risk cytogenetic abnormalities are eligible
• * Myelodysplastic syndromes (MDS) as defined by WHO criteria
• Meets 1 of the following criteria:
• * Over 55 years of age
• * Ineligible for busulfan-based therapy based on diminished organ function or poor performance status
• * Indolent and chemotherapy-responsive CLL, low-grade NHL, small lymphocytic lymphoma, or PLL
• Patients who have undergone prior autologous stem cell transplantation are preferentially enrolled on clinical trial CALGB-100002, if available and patient is eligible
• HLA-matched or mismatched related donor or HLA-matched unrelated donor available
• * HLA-identical sibling (6/6 or 9/10) (minimal serologic typing required for class I \[A, B\]; molecular typing required for class II (DRB1))
• * 9/10 matched unrelated donor (MUD) (molecular analysis at HLA A, B, C, DRB1, and DQB1 by high resolution typing required)
• * 5/6 MUD (molecular analysis at HLA A, B, and DRB1 required)
• * No syngeneic donors
• PATIENT CHARACTERISTICS:
• Creatinine clearance ≥ 40 mL/min
• Bilirubin ≤ 3 times upper limit of normal (ULN)
• aspartate aminotransferase (AST) ≤ 3 times ULN
• Diffusing capacity of the lungs for carbon monoxide (DLCO) \> 40% with no symptomatic pulmonary disease
• Left ventricular ejection fraction (LVEF) ≥ 30% by multigated acquisition scan (MUGA)
• No uncontrolled diabetes mellitus or active serious infection
• No known hypersensitivity to Escherichia coli-derived products
• No HIV infection
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• PRIOR CONCURRENT THERAPY:
• See Disease Characteristics
• More than 4 weeks since prior chemotherapy, radiotherapy (except prophylactic cranial x-ray therapy), or surgery