| Inclusion Criteria: | 1) Patients age >/=18 to </= 65 years.
2) Diagnosis of AML past first remission (i.e., in first or subsequent relapse, in second or greater remission) or primary induction failure; MDS with intermediate or high risk International Prognostic Scoring System (IPSS) score or having failed to respond or recurred after chemotherapy; AML arising from MDS; or CML which failed to respond to imatinib or other tyrosine kinase inhibitor and has >/=5% blasts in the blood or bone marrow.
3) WBC </= 20 x 10^9/l.
4) Patients should have a histocompatible, related or unrelated volunteer donor available. A histocompatible donor is defined as HLA matched related donor or an unrelated donor matched for HLA- A, B, C, and DR antigens by high-resolution DNA techniques.
5) Zubrod performance status 0 or 1.
6) Left ventricular ejection fraction >/= 45 %. No uncontrolled arrhythmias or uncontrolled symptomatic cardiac disease.
7) No symptomatic pulmonary disease. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and diffusion capacity of carbon monoxide (DLCO) >/= 50 % of expected, corrected for hemoglobin.
8) Serum creatinine </=1.5 mg/dl.
9) Serum glutamic pyruvic transaminase (SGPT) </= 200 IU/ml unless related to the malignancy.
10) Total serum bilirubin </=1.5 mg/dl (unless Gilbert's syndrome) and alkaline phosphatase </=2.5 times laboratory standard upper limit of normal (ULN).
11) Patient or patient's legal representative able to sign informed consent. |