Fludarabine, Total-Body Irradiation, and Donor Stem Cell Transplant Followed By Cyclosporine and Mycophenolate Mofetil in Treating Patients With Chronic Myelogenous Leukemia

DISEASE CHARACTERISTICS: Diagnosis of chronic myelogenous leukemia (CML), meeting 1 of the following criteria: First or second chronic phase Philadelphia chromosome-positive (Ph+) disease by cytogenetics or fluorescent in situ hybridization (FISH) First accelerated phase, meeting any of the following criteria: More than 10% but < 30% myeloblasts and promyelocytes in bone marrow or peripheral blood Any additional clonal cytogenetic abnormalities Increasing splenomegally Extramedullary tumor WBC, platelet count, or hematocrit pertubations not controlled by therapy with hydroxyurea, interferon, or imatininb mesylate Persistent unexplained fever or bone pain Less than 5% blasts in marrow at time of transplant No blast crisis No other curative therapy exists Received prior imatinib mesylate AND meets ≥ 1 of the following criteria: Hematologic evidence of disease progression Lack of complete hematologic response after 3 months of treatment with imatinib mesylate Cytogenetic evidence of disease progression, defined as an increase in Ph+ cells or BCR/ABL-positive (BCR/ABL+) cells of > 25% Lack of complete cytogenetic remission (no Ph+ cells by cytogenetic analysis or BCR/ABL+ cells by FISH) after 1 year of treatment with imatinib mesylate At least 65% Ph+ cells by cytogenetic analysis or BCR/ABL+ cells by FISH after 6 months of treatment with imatinib mesylate Less than 3-log reduction in BCR/ABL mRNA levels by quantitative polymerase chain reaction (Q-PCR) compared to a standard baseline level after 1 year of treatment with imatinib mesylate Molecular evidence of disease progression, defined as > 1 log increase in BCR/ABL mRNA levels by Q-PCR, detected in 2 samples Experienced adverse events with imatinib mesylate treatment that would preclude further administration of the drug Patient refused further treatment with imatinib mesylate despite lack of disease progression Refused conventional myeloablative allogeneic stem cell transplantation OR at high risk for regimen-related toxicity due to pre-existing medical conditions (for patients < 50 years of age) Unrelated donor available Matched at HLA-A, -B, -C, -DRB1, and -DQB1 by high-resolution typing A single allele* disparity for HLA-A, -B, or -C allowed Negative anti-donor cytotoxic crossmatch Not a marrow donor NOTE: *Patient and donor pairs homozygous at a mismatched allele (e.g., the patient is A*0101 and the donor is A*0201) are considered a two-allele mismatch and are not allowed No CNS involvement with disease that is refractory to intrathecal chemotherapy PATIENT CHARACTERISTICS: Age Any age Performance status Karnofsky 70-100% Lanksy 50-100% (for pediatric patients) Life expectancy Not specified Hematopoietic See Disease Characteristics Hepatic No fulminant liver failure No cirrhosis of the liver with evidence of portal hypertension No alcoholic hepatitis No esophageal varices No history of bleeding esophageal varices No hepatic encephalopathy No uncorrectable hepatic synthetic dysfunction evidenced by prolongation of PT No ascites related to portal hypertension No bacterial or fungal liver abscess No biliary obstruction No chronic viral hepatitis AND bilirubin > 3 mg/dL No symptomatic biliary disease Renal Not specified Cardiovascular Ejection fraction ≥ 40% No cardiac failure requiring therapy No poorly controlled hypertension (i.e., blood pressure ≥ 150/90 mm Hg despite standard medication) Pulmonary DLCO ≥ 35% (corrected) No requirement for supplementary continuous oxygen Pulmonary nodules allowed at the discretion of the principal investigator Immunologic HIV negative No uncontrolled systemic infection No fungal infection with radiological progression after treatment with amphotericin B or active triazole for > 1 month Other Not pregnant or nursing Fertile patients must use effective contraception during and for 12 months after completion of study treatment No other active malignancy except nonmelanoma skin cancer No prior localized malignancy at high risk (≥ 20%) of recurrence PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics See Chemotherapy Chemotherapy See Disease Characteristics More than 3 weeks since prior cytotoxic chemotherapy Imatinib mesylate and interferon are not considered cytotoxic chemotherapy Endocrine therapy Not specified Radiotherapy Not specified Surgery Not specified