Reduced Intensity Preparative Regimen Followed by Stem Cell Transplant (FAB)

Inclusion Criteria:

1. Diagnosis of myelodysplastic and myeloproliferative disorders, acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, multiple myeloma, plasma cell dyscrasia, lymphoproliferative disorders (non-Hodgkin lymphoma, hairy cell leukemia, chronic lymphocytic leukemia, and Hodgkin's disease) and non malignant hematologic diseases considered treatable with an allogeneic transplant including but not limited to bone marrow failure syndrome, hemoglobinopathy and severe immunodeficiency states.
2. Performance status 0-2 on Zubrod scale
3. Ejection fraction \> 30%
4. AST/ALT and bilirubin not \> 4 times normal
5. FEV1 greater than 1.0 and diffusion capacity \> 40%
6. Age birth to 70 years of age
7. Conditions that increase treatment related mortality (need more than one to be eligible):

   * Age \> 35 years
   * EF of less than 45%
   * DLCO less than 50% or FEV1 50-75% of predicted value
   * Diabetes mellitus
   * Renal insufficiency, defined by increase in serum creatinine level of 1.5 times ULN or decrease in GFR by 25%
   * Prior recent history of systemic fungal infection
   * 3rd or greater remission of AML or ALL
   * More than 1 year of diagnosis (CML or myeloma patients only)
   * Multiple types of treatment regimens (equal to or more than 3)
   * Prior autologous or allogeneic stem cell transplantation
   * Significant Grade III or IV neurologic or hepatic toxicity as defined by NCI CTC toxicity from previous treatment
   * No matched sibling donor
8. Available healthy donor without any contraindications for donation

   * 5/6 or 6/6 related
   * 5/6 or 6/6 unrelated (molecular typing for DRB1)
9. Patient and/or responsible person able to understand and sign consent
10. For women of childbearing potential, negative pregnancy test

Exclusion Criteria:

1. Pregnant and lactating women or women unwilling to use contraception.
2. HIV positive patient.
3. Uncontrolled intercurrent infection.
4. Refractory AML or ALL.
5. Untreated blast crisis for CML.
6. Uncontrolled high-grade lymphoproliferative disease/lymphoma.
7. Unstable angina and uncompensated congestive heart failure (Zubrod of 3 or greater).
8. Severe chronic pulmonary disease requiring oxygen (Zubrod of 3 or greater).
9. Hemodialysis dependent.
10. Active Hepatitis or cirrhosis with total bilirubin, SGOT, and SGPT greater than 3 x normal.
11. Serum creatinine \>2x ULN.
12. Unstable cerebral vascular disease and recent hemorrhagic stroke (less than 6 months).
13. Active CNS disease from hematological disorder.