Allogeneic Stem Cell Transplant After ATG, High-Dose Melphalan, and Fludarabine for Patients With Breast Cancer

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the breast

  * Metastatic disease
* Meets 1 of the following criteria:

  * Chemotherapy-unresponsive disease defined as 1 of the following:

    * Less than a partial response to 2 consecutive chemotherapy regimens that included an anthracycline and a taxane in combination or succession
    * Progression of disease during or within 3 months of completion of a taxane, anthracycline, or platinol-based regimen
  * Histologically confirmed tumor involvement on bone marrow biopsy
* Measurable or evaluable disease\* defined as the following:

  * Bidimensionally reproducible measurable mass by physical examination, ultrasonography, radiography, CT scan, or MRI
  * Evaluable lesions apparent on clinical exam, x-ray, CT scan, or MRI which do not fit the criteria for measurability (e.g., ill-defined post-surgical masses or masses assessable in 1 dimension only)

    * Elevation of biological markers (e.g., CA 27.29) is considered evaluable disease NOTE: \*Bone lesions or pleural or peritoneal effusion alone are not considered measurable or evaluable disease
* Appropriate candidate for allogeneic stem cell transplantation
* No active CNS metastases
* Available HLA-identical sibling donor

  * 6/6 antigen match
  * Donor CD34 cells at least 2 times 10\^6/kg recipient weight
* Hormone receptor status:

  * Estrogen receptor negative or positive

    * Estrogen receptor positive tumors must demonstrate progression on at least 1 hormonal manipulation

PATIENT CHARACTERISTICS:

Age

* 18 to 60

Sex

* Female

Menopausal status

* Not specified

Performance status

* Karnofsky 70-100% OR
* ECOG 0-1

Life expectancy

* Not specified

Hematopoietic

* WBC at least 1,500/mm\^3
* Platelet count at least 30,000/mm\^3

Hepatic

* Bilirubin less than 3 times normal\*
* AST and ALT less than 3 times normal\* NOTE: \*Unless abnormality due to malignancy

Renal

* Creatinine no greater than 1.6 mg/dL

Cardiovascular

* LVEF greater than 40% by echocardiography or MUGA
* No myocardial infarction within the past 6 months

Pulmonary

* DLCO greater than 40% of predicted

Other

* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* HIV negative
* No serious localized or systemic infection
* No hypersensitivity to E. coli-derived products
* No history of non-breast malignant disease within the past 5 years except completely excised nonmelanoma skin cancer or carcinoma in situ of the cervix
* No chronic inflammatory disorder requiring concurrent glucocorticosteroids or other immunosuppressive medication
* No psychological condition or social situation that would preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* See Disease Characteristics

Endocrine therapy

* No concurrent glucocorticoids

Radiotherapy

* No prior radiotherapy to an indicator lesion unless the lesion shows evidence of progression after discontinuation of the therapy

Surgery

* Not specified

Other

* No concurrent immunosuppressive medication