Bone Marrow Transplantation in Treating Patients With Hematologic Cancer

DISEASE CHARACTERISTICS:

Histologically proven hematologic malignancy of 1 of the following types:

Chronic myelogenous leukemia (CML) in chronic, accelerated, or blast* phase

Acute leukemia with high-risk features at diagnosis such as:

Philadelphia chromosome-positive acute lymphocytic leukemia**
Acute myeloid leukemia with high-risk cytogenetics such as inv (3), t(3;3) del(5q), -5, del(7q), -7, +8, +11, abnormal 12p, del(20q), -20, or complex abnormalities**
Acute leukemia with failure after one course of induction chemotherapy
Acute leukemia in first relapse* or second remission
High-risk lymphoblastic lymphoma in first remission
Non-Hodgkin's lymphoma, Hodgkin's disease, or other malignant lymphoproliferative disease after first remission, if an autologous transplantation is not indicated
Myelodysplastic or myeloproliferative syndromes ineligible for Protocol FHCRC-179 NOTE: * For patients with acute leukemia in relapse or CML in blast crisis, the search for an unrelated donor begins only if: High probability that the patient's medical condition will remain stable for the 3 to 6-month period needed to find a donorAn attempt at remission induction has been undertaken Referring physician and patient accept possibility that search for donor will be canceled if patient's condition worsens

NOTE: ** For newly diagnosed patients with high-risk acute leukemia, early referral is encouraged so that an unrelated donor search may begin immediately

Availability of an unrelated donor with:

1 HLA-A or B non-cross-reactive group (non-CREG) mismatch (except in CML in chronic phase or myelodysplastic syndrome) OR
1 HLA-A or B CREG mismatch OR

An HLA-A, B, and C match with an HLA-DRB1 or DQB1 mismatch (no double mismatch) if 1 of the above 2 donor types unavailable

No more than 1 HLA-A, B, and C mismatch

No availability of an HLA-identical sibling or haploidentical relative incompatible for 0 or 1 HLA-A or B locus of the nonshared haplotypes

For patients with diagnosis other than CML in chronic phase, 1 HLA-DR locus-incompatible related donor has priority over an HLA compatible or class IA or B CREG locus antigen-incompatible unrelated donor
No severe aplastic anemia
No leukoencephalopathy

PATIENT CHARACTERISTICS:

Age:

Under 51
Eligible for transplantation until age 52 if the donor is identified prior to patient's 51st birthday

Performance status:

Not specified

Life expectancy:

Not specified

Hematopoietic:

See Disease Characteristics

Hepatic:

No severe hepatic disease, including acute hepatitis

Renal:

Creatinine less than 2 times normal

Cardiovascular:

No cardiac insufficiency requiring treatment
No symptomatic coronary artery disease

Pulmonary:

No severe hypoxemia (i.e., PO2 less than 70 mm Hg) with decreased DLCO (i.e., DLCO less than 70% predicted) OR
No mild hypoxemia (i.e., PO2 less than 80 mm Hg) with severely decreased DLCO (i.e., DLCO less than 60% predicted)
No pulmonary fibrosis

Other:

No other nonmalignant disease that would severely limit life expectancy
HIV negative
No contraindication to total body irradiation (TBI)
Patients excluded from this study because of contraindication to TBI may be treated on protocol FHCRC-739

PRIOR CONCURRENT THERAPY:

Biologic therapy:

See Disease Characteristics

Chemotherapy:

See Disease Characteristics

Endocrine therapy:

Not specified

Radiotherapy:

No prior radiotherapy greater than 3,000 cGy to whole brain
At least 6 months since prior involved-field radiotherapy greater than 1,500 cGy to chest or abdomen

Surgery:

Not specified