Study of Stem Cell Transplantation for Hematologic Malignancies Using Clofarabine and Busulfan Regimen

Inclusion Criteria:

Disease Criteria

* Acute leukemia or chronic myelogenous leukemia in blastic crisis or accelerated phase, not in remission at the time of transplant
* Myelodysplastic syndrome, with more than 5% blasts in bone marrow at the time of transplant
* Hodgkin and Non-Hodgkin Lymphomas: Not in CR in PET scan or CT scan before transplant, or relapsed within 1 year from previous remission
* CLL not in remission
* Multiple Myeloma, not in remission
* Suitable donor available (related or unrelated)

Age, Organ Function Criteria

* Age: ≤ 70 years
* Cardiac: LV Ejection Fraction ≥ 40% by MUGA or Echocardiogram
* Pulmonary: FEV1 and FVC ≥ 40% predicted, and DLCO (corrected for hemoglobin) ≥ 40% of predicted
* Renal: Adult population: serum creatinine ≤ 1.0 mg/dL (if serum creatinine \> 1.0 mg/dL, then the estimated glomerular filtration rate (GFR) must be \> 60 mL/min/1.73 m2 as calculated by the Modification of Diet in Renal Disease equation)
* Renal: Pediatric population: serum creatinine clearance ≥ 90 ml/min/1.73 m2 as calculated by the Schwartz formula for estimated GFR
* Hepatic: serum total bilirubin ≤ 2.0 mg/dl and AST / ALT ≤ ULN x 4
* Performance status: Karnofsky ≥ 70%

Exclusion Criteria:

* Other active life-threatening cancer requiring treatment other than allo-HSCT
* HIV1 or HIV2 positive
* Uncontrolled medical or psychiatric disorder
* Uncontrolled viral or fungal infection
* Active CNS leukemia
* Non-compliant to medications
* No appropriate caregivers identified