Alemtuzumab, Busulfan, and Cyclophosphamide Followed By a Donor Stem Cell Transplant in Treating Patients With Hematologic Cancer

DISEASE CHARACTERISTICS:

Confirmed diagnosis of one of the following:

Primary acute myeloid leukemia (AML) meeting any of the following criteria:

First complete remission (CR; defined as < 5% blasts in marrow) with high-risk features as defined by failure to achieve remission by day 21 after induction chemotherapy, or the presence of chromosomal abnormalities involving any of the following:

-5/del(5q)
-7/del(7q)
Inversion 3q
Abnormalities of 11q23, 20q, 21q, del(9q),
Translocation 6;9
Translocation 9;22
Abnormalities of 17p
Complex karyotype with ≥ 3 abnormalities
Second CR or subsequent in remission
Refractory or relapsed disease
Secondary AML in remission or relapse

Chronic myelogenous leukemia (CML) in accelerated or blast phase meeting the following criteria:

Accelerated phase is defined by any one of the following:

Blasts 10% to 19% of peripheral blood white cells or bone marrow cells
Peripheral blood basophils ≥ 20%
Persistent thrombocytopenia (< 100,000/mm³) unrelated to therapy, or persistent thrombocytosis (> 1,000,000/mm³) unresponsive to therapy
Increasing spleen size and increasing WBC count unresponsive to therapy
Cytogenetic evidence of clonal evolution (i.e., the appearance of an additional genetic abnormality that was not present in the initial specimen at the time of diagnosis of chronic phase CML)

Blast phase is defined by any of the following:

Blasts ≥ 20% of peripheral blood white cells or bone marrow cells
Extramedullary blast proliferation
Large foci or clusters of blasts in bone marrow biopsy
Primary myelodysplastic syndromes (MDS) with an IPSS score > 1.5
Secondary MDS with any IPSS score

Primary acute lymphoblastic leukemia meeting any of the following criteria:

First CR (< 5% blasts in marrow) with high-risk features as defined by 1 of the following:

Failure to achieve remission after first induction chemotherapy
Presence of chromosomal abnormalities including hypodiploidy or abnormalities of 11q23 or translocation 9;22
Second CR or subsequent in remission
Refractory or relapsed disease
No patients for whom a suitable HLA genotypically identical sibling or fully matched HLA-A, -B, -C, and -DRB1 unrelated donor is available
No active CNS involvement with disease

Donors must meet the following criteria:

Unrelated volunteer donors who are mismatched for more than one HLA-class I alleles or antigens or for one HLA-class I antigen, but matched by high-resolution typing at HLA-DRB1 and -DQB1, OR who are mismatched for one or more HLA-class II alleles or antigens, but matched by high-resolution typing at HLA-A, -B, and -C

No two-antigen mismatch at a single HLA-A, -B, or -C locus
No mismatching of class I and class II HLA
Matching must be based on results of high-resolution typing at HLA-A, -B, -C, - DRB1, and -DQB1

PATIENT CHARACTERISTICS:

Karnofsky performance status 50-100%
No symptomatic coronary artery disease or symptomatic congestive heart failure
No hepatic disease with transaminases or bilirubin > 2 times upper limit of normal except for isolated hyperbilirubinemia attributed to Gilbert's syndrome
No severe hypoxemia with room air P_AO_2 < 70, supplemental oxygen-dependence, or DLCO < 60% predicted
No impaired renal function with creatinine > 2 times upper limit of normal or creatinine clearance < 50% normal
Not HIV seropositive
Not pregnant or breast-feeding
Fertile patients must use effective contraception
No active infections that are untreated or failing to respond to appropriate therapy

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

See Disease Characteristics

Exclusion criteria:

Prior allogeneic or autologous bone marrow, peripheral blood stem cell, or umbilical cord blood transplantation using a high-dose total-body irradiation regimen