Laboratory-Treated Lymphocyte Infusion After Haploidentical Donor Stem Cell Transplant

DISEASE CHARACTERISTICS:

Diagnosis of 1 of the following:

Acute lymphocytic leukemia

In ≥ second complete remission (CR), defined as < 5% blasts in bone marrow (BM) and no active extramedullary disease OR in first CR with any of the following high risk features:

History of induction failure
Philadelphia chromosome positive
t(4;11) by cytogenetic analysis
Any infant with MLL rearrangements on cytogenetic analysis
No relapse with isolated extramedullary disease after completion of prior treatment

Acute myeloid leukemia

Failed induction therapy after < 3 courses

In ≥ second CR, defined as < 5% blasts in BM and no active extramedullary disease OR in first CR with any of the following high-risk features:

History of induction failure = 5q- or monosomy 7 cytogenetic findings

Any of the following myelodysplastic syndromes:

Refractory anemia (RA) with excess blasts (RAEB) with a high International Prognostic Scoring System (IPSS) score or score of intermediate-1(INT-1) or intermediate-2 (INT-2)
RAEB in transformation with INT-1, INT-2, or high IPSS score
RA with INT-2 score

Patients must have a healthy, related donor who is at least genotypically HLA-A, B, C, and DR haploidentical to the patient

No suitably matched family donor defined by genotypic or phenotypic identity for ≥ 5/6 A, B, or DR loci
No immediately available genotypically matched (6/6) unrelated marrow donor
No immediately available umbilical cord blood donor with suitable cell dose after a search ≥ 2 months
Patients whose medical condition is at high risk of deteriorating or whose disease is at high risk of progression during a donor search are eligible
Has a parent with a haplotype that is disparate from that of the donor for the haplotype shared by the patient and parent, but not shared by the patient and donor OR patient is able to donate sufficient autologous cells by peripheral blood draw or unstimulated leukapheresis
No active CNS disease

PATIENT CHARACTERISTICS:

Room air O_2 saturation > 95% unless the lungs are involved with disease
No clinical evidence of pulmonary insufficiency unless the lungs are involved with disease
AST and ALT < 3 times upper limit of normal (ULN)*
Bilirubin < 2.0 mg/dL*
Creatinine < 2 times ULN OR creatinine clearance or glomerular filtration rate > 50% of the lower limit of normal
LVEF > 45% OR shortening fraction > 20%
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No active infection, defined as absence of an infectious diagnosis or (in patients who have had a recent positive infectious diagnosis) the resolution of fever, documentation of negative cultures or antigen testing, continuation or completion of a course of appropriate therapy, and presence of stable to resolving clinical symptoms
No evidence of HIV infection OR known HIV positivity NOTE: *Does not apply if liver is involved with disease

PRIOR CONCURRENT THERAPY:

See Disease Characteristics
No prior stem cell transplantation
No other concurrent immunosuppressive therapy