Low-Dose Fludarabine, Busulfan, and Anti-Thymocyte Globulin Followed By Donor Umbilical Cord Blood Transplant in Treating Patients With Advanced Hematologic Cancer

DISEASE CHARACTERISTICS:

Diagnosis of 1 of the following advanced hematologic malignancies:

Acute myeloid leukemia (AML) meeting the following criteria:

Considered incurable with chemotherapy
Marrow blasts ≤ 10% (may be achieved using standard chemotherapy regimen)

Meets any of the following criteria:

High-risk cytogenetics (-7, -7q, -5, -5q, t(6,9), t(9,11), complex [≥ 3 abnormalities], Philadelphia chromosome positive [Ph+])
AML evolved from prior myelodysplasia
AML secondary to prior chemotherapy
Failed to achieve remission
In second or subsequent remission
Refractory relapse

Myelodysplastic syndromes (MDS) meeting the following criteria:

Must have high-risk features, including any of the following:

Intermediate-2 or high risk International Prognostic Scoring System (IPSS) score
Chronic myelomonocytic leukemia
Marrow blasts ≤ 20% (chemotherapy may be given to achieve target blast levels)
No rapidly progressive disease

Acute lymphoblastic leukemia meeting the following criteria:

Considered incurable with chemotherapy

Meets any of the following criteria:

High-risk cytogenetics (Ph+, t(4,11), 11q23 abnormalities, or monosomy 7)
Required > 1 induction course to achieve remission
Failed to enter remission
In second or subsequent remission
Marrow blasts ≤ 10% (chemotherapy may be given to achieve target blast levels)

Chronic myelogenous leukemia (CML) meeting 1 of the following criteria:

Chronic phase CML that failed imatinib mesylate therapy, as defined by progressive disease or failed to achieve a major cytogenetic response at 1 year after initiation of therapy

Accelerated phase CML meeting 1 of the following criteria:

Failed to achieve a complete cytogenetic remission at 1 year after initiation of therapy
Failed to achieve any cytogenetic response after 6 months of therapy
Progressive disease, as demonstrated by worsening cytogenetic response in 2 consecutive analyses separated by 4 weeks
In blast crisis with < 10% blasts in bone marrow

Multiple myeloma meeting the following criteria:

Stage I-III disease

Meets any of the following criteria:

In relapse after autologous transplantation
Refractory to ≥ 2 prior conventional myeloma therapies
Chromosome 13 abnormalities (may be enrolled at diagnosis or after initial progression)

Lymphoma

The following subtypes are eligible:

Diffuse large cell
Follicular large cell
Mantle cell
Peripheral T-cell
T-natural killer (T-NK) cell
Hodgkin's lymphoma
Must have progressed, recurred after prior therapy, or failed to respond to primary therapy
Relapsed disease after autologous stem cell transplantation (SCT) allowed

Low-grade non-Hodgkin's lymphoma meeting 1 of the following criteria:

Relapsed or refractory disease after ≥ 2 chemotherapy-based treatment regimens
Relapsed after autologous SCT

Chronic lymphocytic leukemia

Relapsed or refractory disease after ≥ 2 chemotherapy-based treatment regimens
Relapsed after autologous SCT

Meets 1 of the following criteria:

Age 55-70 years

Under age 55 and deemed ineligible for conventional high-dose chemotherapy, as indicated by any of the following:

Poor cardiac function (i.e., LVEF < 40%)
Poor pulmonary function (i.e., DLCO < 50%)
Hepatic dysfunction
Prior myeloablative therapy
Not eligible for autologous SCT or conventional therapy

Umbilical cord blood donor available

Matched at ≥ 4 of 6 HLA antigens (A, B, and DR)
Has 1-3 units of umbilical cord blood available
Must not have an HLA-identical or 1 antigen mismatched related donor or potential HLA-matched unrelated donor readily available NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology.

PATIENT CHARACTERISTICS:

ECOG performance status 0-2
Creatinine clearance > 40 mL/min
Creatinine < 2.0 mg/dL
AST and alkaline phosphatase < 3 times upper limit of normal (ULN)
Bilirubin < 2.0 mg/dL

Hepatitis C or active hepatitis B virus (HBV) allowed if ≤ grade 2 fibrosis and/or inflammation by liver biopsy

Patients with history of HBV infection should be tested for hepatitis B epsilon (HBe) antigen, anti-HBe, and HBV DNA (quantitative)
Patients with active HBV viral replication should receive antiviral therapy
Ejection fraction > 30%
DLCO ≥ 40%
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No active infection requiring ongoing antibiotic treatment
HIV negative

PRIOR CONCURRENT THERAPY:

See Disease Characteristics