Nonmyeloablative Allogeneic Peripheral Blood Stem Cell Transplantation From HLA Matched Related Donors for Treatment of Older Patients With De Novo or Secondary Acute Myeloid Leukemia in First Complete Remission

Inclusion Criteria:

- Patients with de novo AML (French-American-British [FAB] MO-M2, M4-M7) or secondary
AML who achieve CR1 after induction chemotherapy and one or two cycles of
consolidation chemotherapy

- Transplant conditioning must occur within 6 months of diagnosis

- Patient enrollment must be approved by the Fred Hutchinson Cancer Research Center
(FHCRC) principal investigator (PI) or the PI's designee

- DONOR: Related donor who is genotypically or phenotypically identical

- DONOR: Age >= 12 years

- DONOR: Donor must consent to filgrastim (G-CSF) administration and leukapheresis

- DONOR: Donor must have adequate veins for leukapheresis or agree to placement of
central venous catheter (femoral, subclavian)

Exclusion Criteria:

- AML FAB M3

- AML involvement of the central nervous system (CNS) as defined by a positive cytospin
of cerebral spinal fluid at the time of enrollment

- Presence of circulating leukemic blasts (in the peripheral blood) detected by
standard pathology

- Human immunodeficiency virus (HIV) seropositivity

- Fungal infections with radiographic progression after receipt of amphotericin B or
active triazole for greater than one month

- Diffusion capacity of carbon monoxide (DLCO) corrected < 40%

- Total lung capacity (TLC) < 40%

- Forced expiratory volume in one second (FEV1) < 40% or requiring supplementary oxygen

- The FHCRC principal investigator of the study must approve enrollment of all patients
with pulmonary nodules

- Cardiac ejection fraction < 40%

- Patients with clinical or laboratory evidence of liver disease would be evaluated for
the cause of liver disease, its clinical severity in terms of liver function,
bridging fibrosis, and the degree of portal hypertension; patients will be excluded
if they are found to have fulminant liver failure, cirrhosis of the liver with
evidence of portal hypertension, alcoholic hepatitis, esophageal varices, a history
of bleeding esophageal varices, hepatic encephalopathy, uncorrectable hepatic
synthetic dysfunction evinced by prolongation of the prothrombin time, ascites
related to portal hypertension, bacterial or fungal liver abscess, biliary
obstruction, chronic viral hepatitis with total serum bilirubin > 3mg/dL, or
symptomatic biliary disease

- Karnofsky Performance Score < 70

- Fertile men or women unwilling to use contraceptive techniques during and for 12
months following treatment

- Females who are pregnant or breastfeeding

- No intensive chemotherapy can be given within three weeks (or the interval in which a
cycle of standard chemotherapy would be administered in a non-transplant setting)
prior to initiating the nonmyeloablative transplant conditioning

- Patients with active non-hematologic malignancies (except non-melanoma skin cancers)

- Patients with a history of non-hematologic malignancies (except non-melanoma skin
cancers) currently in a complete remission, who are less than 5 years from the time
of complete remission, and have a > 20% risk of disease recurrence

- Patients with active bacterial or fungal infections unresponsive to medical therapy

- DONOR: Identical twin

- DONOR: Pregnancy

- DONOR: HIV seropositivity

- DONOR: Inability to achieve adequate venous access

- DONOR: Known allergy to G-CSF

- DONOR: Current serious systemic illness