Busulfan, Melphalan, and Fludarabine With Peri-transplant Palifermin, Followed by a T-Cell Depleted Hematopoietic Stem Cell Transplant From HLA Matched or Mismatched Related or Unrelated Donors in Patients With Advanced Myelodysplastic Syndromes (MDS) and Acute Myeloid Leukemia (AML)

Inclusion Criteria

• •Patients should be \< 65 years. Patients \> or equal to 65 years will be accrued on a case by case basis after discussion and approval by the BMT Service.
• •Patients may be of either gender or any ethnic background.
• •Patients must have a Karnofsky or Lansky Performance Status \> or equal to 70%.
• •Patients must have adequate organ function measured by:
• •\* Cardiac: asymptomatic or if symptomatic then LVEF at rest must be \> or equal to 50% and must improve with exercise.
• •Hepatic: \< 3x ULN ALT and \< 1.5 total serum bilirubin, unless there is congenital benign hyperbilirubinemia.
• •* Renal: serum creatinine \< than or equal to 1.2 mg/dl or if serum creatinine is outside the normal range, then CrCl \> 60-ml/min/1.73 m2
• •* Pulmonary: asymptomatic or if symptomatic, DLCO \> 50% of predicted (corrected for hemoglobin)
• •Each patient must be willing to participate as a research subject and must sign an informed consent form.
• •Parent or legal guardians of patients who are minors will sign the informed consent form.