Non-Myeloablative Bone Marrow Transplant for Patients With Sickle Cell Anemia and Other Blood Disorders

You may be eligible if

• DISEASE CHARACTERISTICS:
• Diagnosis of 1 of the following sickle cell anemias (Hb SS):
• * Hb S/β° thalassemia
• * Hb S/β+ thalassemia
• * Hb SC disease
• * Hb SE disease
• * Hb SD disease
• * Hemoglobin SO-Arab disease
• * Hb S/hereditary persistence of fetal hemoglobin
• Meets 1 of the following criteria:
• * History of invasive pneumococcal disease
• * Stroke or CNS event lasting \> 24 hours
• * MRI changes indicative of brain parenchymal damage
• * Evidence of cerebrovascular disease by magnetic resonance angiography
• * Acute chest syndrome requiring exchange transfusion or hospitalization
• * Recurrent vaso-occlusive pain crisis (\> 2 per year for the last 2 years)
• * Stage I or II sickle lung disease
• * Sickle retinopathy
• * Osteonecrosis
• * Red cell alloimmunization (\> 2 antibodies) during long-term transfusion
• * Constellation of dactylitis in the first year of life AND a baseline hemoglobin \< 7 g/dL and leukocytosis (WBC \> 13.4/mm\^3) in the absence of infection during the second year of life
• * Pitted RBC count \> 3.5% during the first year of life
• Ineligible for or refused bone marrow transplantation from an HLA-matched sibling donor
• Partially mismatched (at least haploidentical) first-degree relative donor available
• * No minor (donor anti-recipient) ABO incompatibility if an ABO compatible donor is available
• PATIENT CHARACTERISTICS:
• ECOG performance status (PS) 0-1 OR Karnofsky or Lansky PS 70-100%
• LVEF ≥ 35%
• FEV\_1 and forced vital capacity ≥ 40% predicted
• Direct bilirubin \< 3.1 mg/dL
• No moderate to severe pulmonary hypertension by ECHO
• No debilitating medical or psychiatric illness that would preclude study participation
• No HIV positivity
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• PRIOR CONCURRENT THERAPY:
• No prior transfusions from donor
• No immunosuppressive agents, including steroids as antiemetics, within 24 hours after the last dose of post-transplantation cyclophosphamide