Umbilical Cord Blood Transplantation in Treating Patients With Hematologic Cancer or Nonmalignant Hematologic Disease

DISEASE CHARACTERISTICS:

* One of the following diagnoses:

  * Acute myeloid leukemia (AML), with or without myelodysplastic syndromes

    * Not in first complete remission (CR)\* with translocations t(8;21) and inv (16) unless failure of first-line induction therapy
    * Not in first CR\* with translocations t(15;17) abnormality unless:

      * Failure of first-line induction therapy OR
      * Molecular evidence of persistent disease
    * Not in first CR with Down syndrome
    * Patients with third or greater medullary relapse or refractory disease (other than primary induction failures) receive busulfan/melphalan conditioning regimen NOTE: \* CR defined by no greater than 5% blasts in marrow
  * Acute lymphocytic leukemia (ALL)

    * Not in first CR OR
    * High-risk ALL in first CR, with high risk defined as one of the following:

      * Hypoploidy (no greater than 44 chromosomes)
      * Pseudodiploidy with translocations or molecular evidence of t(9;22), 11q23, or t(8;14) (except B-cell ALL) with or without MLL gene arrangement
      * Elevated WBC at presentation

        * Age 6-12 months: greater than 100,000/mm\^3
        * Age 10-17 years: greater than 200,000/mm\^3
        * Age 18: greater than 20,000/mm\^3
      * Failed to achieve CR after 4 weeks of induction therapy
    * Patients with B-ALL must not be in first CR, must meet at least one of the high-risk criteria specified above, or must not meet any of the following criteria:

      * Translocation t(8;14)
      * Blasts have surface immunoglobulins
      * CD10 positive
    * Patients with third or greater medullary relapse or refractory disease (other than primary induction failures) receive busulfan/melphalan conditioning regimen
  * Chronic myelogenous leukemia, meeting criteria for 1 of the following:

    * Accelerated phase
    * Chronic phase if 1 year from diagnosis without a matched unrelated bone marrow donor AND unresponsive to or unable to tolerate interferon
    * Blast crisis, defined as greater than 30% promyelocytes plus blasts in bone marrow

      * Patients receive busulfan/melphalan conditioning regimen
  * Acute undifferentiated leukemia (AUL), infant leukemia, or biphenotypic leukemia

    * Patients with third or greater medullary relapse or refractory disease (other than primary induction failures) receive busulfan/melphalan conditioning regimen
  * Juvenile myelomonocytic leukemia meeting the following criteria:

    * No Philadelphia chromosome
    * Bone marrow blasts less than 30%
    * Peripheral blood monocytes greater than 1,000/mm\^3
    * At least 2 of the following:

      * Peripheral blood spontaneous growth and/or sargramostim (GM-CSF) hypersensitivity
      * Increased hemoglobin F for age
      * Clonal abnormalities (e.g., monosomy 7 or RAS mutations)
      * Peripheral blood with myeloid precursors
      * WBC greater than 10,000/mm\^3
  * Myelodysplastic syndromes defined by the following:

    * Refractory anemia (RA)
    * RA with ringed sideroblasts
    * RA with excess blasts (RAEB)
    * RAEB in transformation
    * Chronic myelomonocytic leukemia
  * Paroxysmal nocturnal hemoglobinuria
  * Hodgkin's lymphoma or non-Hodgkin's lymphoma beyond first CR or primary induction failures AND chemosensitive (greater than 50% reduction in tumor mass size)
  * Inborn error of metabolism including, but not limited to, Hurler's syndrome, adrenoleukodystrophy (ALD), Maroteaux-Lamy syndrome, globoid cell leukodystrophy, metachromatic leukodystrophy, fucosidosis, or mannosidosis

    * For ALD patients over age 5, IQ must be at least 80
    * For all other patients over age 5, IQ must be at least 70
    * For all patients age 5 and under, developmental quotient or clinical neurodevelopmental examination should demonstrate potential for stabilization at a level of functioning where continuous life support (e.g., mechanical ventilation) would not be predicted to be required in the year after transplantation
  * Combined immune deficiencies including, but not limited to:

    * Severe combined immunodeficiency (SCID) requiring cytoreduction
    * Wiskott-Aldrich syndrome
    * Leukocyte adhesion defect
    * Chediak-Higashi disease
    * X-linked lymphoproliferative disease
    * Adenosine deaminase deficiency
    * Purine nucleoside phosphorylase deficiency
    * X-linked SCID
    * Common variable immune deficiency
    * Nezelof's syndrome
    * Cartilage hair hypoplasia
* No dyskeratosis congenita
* No ALL, AML, AUL, or biphenotypic leukemia in third or higher medullary relapse or refractory disease other than primary induction failure
* No primary myelofibrosis or myelofibrosis grade 3 or worse
* No active CNS leukemia involvement (CSF with WBC greater than 5/mm\^3 and malignant cells on cytospin)
* No consenting 5/6 or 6/6 HLA-matched related donor available
* 3-6/6 HLA-matched unrelated umbilical cord blood donor available

PATIENT CHARACTERISTICS:

Age:

* See Disease Characteristics
* 18 and under

Performance status:

* Karnofsky 70-100%, if age 16 to 18
* Lansky 50-100%, if under age 16

Life expectancy:

* Not specified

Hematopoietic:

* See Disease Characteristics

Hepatic:

* Bilirubin less than 2.5 mg/dL
* SGOT less than 5 times upper limit of normal

Renal:

* Creatinine normal for age OR
* Creatinine clearance or glomerular filtration rate greater than 50% lower limit of normal for age

Cardiovascular:

* If symptomatic:

  * LVEF greater than 40% (or shortening fraction greater than 26%) and improves with exercise OR
  * Shortening fraction greater than 26%

Pulmonary:

* If symptomatic:

  * DLCO, FEV\_1, and FEC greater than 45% predicted OR
  * Oxygen saturation greater than 85% on room air

Other:

* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* HIV negative
* No uncontrolled viral, bacterial, or fungal infection

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* See Disease Characteristics
* At least 1 year since prior allogeneic stem cell transplantation (SCT) with cytoreductive preparative therapy
* At least 6 months since prior autologous SCT
* No concurrent thrombopoietic growth factors

Chemotherapy:

* See Disease Characteristics
* See Biologic therapy

Endocrine therapy:

* Not specified

Radiotherapy:

* Not specified

Surgery:

* Not specified