Low-Dose Total-Body Irradiation and Fludarabine Phosphate Followed by Unrelated Donor Stem Cell Transplant in Treating Patients With Fanconi Anemia

Inclusion Criteria: Any patient with marrow failure and increased chromosome fragility as determined in the diepoxybutane (DEB) or mitomycin C test Any patient with Fanconi anemia (FA) with marrow failure meeting the following criteria: Granulocyte count < 0.2 x 10^9/L Platelet count < 20 x 10^9/L Hemoglobin < 8 g/dl Corrected reticulocyte count <1% Any patient with FA as determined by DEB fragility, who has life-threatening marrow failure involving a single hematopoietic lineage Any patient with FA and pre-existing cytogenetic abnormality including hematopoietic malignancy (myelodysplastic syndromes [MDS] or acute myeloid leukemia [AML]) in remission DONOR: Unrelated Donors who are prospectively: Matched for human lymphocyte antigen (HLA)-DRB1 and DQB1 alleles (must be defined by high resolution typing); only a single allele disparity will be allowed for HLA -A, B, or C as defined by high resolution typing DONOR: HLA typing will be performed at the highest level of resolution available at the time of transplant Exclusion Criteria: Evidence for hematopoietic malignancy in relapse Heart or lung disease that would prevent compliance with conditioning and GvHD regimen or would severely limit the probability of survival Human immunodeficiency virus (HIV) seropositive patients Females who are pregnant or breastfeeding, or unwilling to use contraceptive techniques during and for the 12 months following treatment DONOR: Donors who by DEB testing are found to have FA DONOR: Donors who test positive in the lymphocytotoxic crossmatch assay DONOR: Donors who are HIV positive DONOR: Donors who for other medical or psychological reasons are not suitable as donors