Inclusion Criteria

Inclusion

- Patients with the following diagnoses are eligible for this study: Advanced myeloid
malignancy with a disease status of more than second remission, induction failure, or
relapse; Chronic myeloid leukemia in blast crisis; Myelodysplasia, specifically
refractory anemia with excess blasts (RAEB)

- All candidates for this study must have a HLA (-A, -B, -C, -DR) identical sibling who
is willing to donate bone marrow or primed blood stem cells or a 10/10 allele-matched
unrelated donor or minor mismatches as per BMT SOP that allows Tacrolimus and
Sirolimus to be given for GVH prophylaxis; all ABO blood group combinations of the
donor/recipient are acceptable since even major ABO compatibilities can be dealt with
by various techniques (red cell exchange or plasma exchange)

- Prior therapy with VP-16, busulfan, hydrea and gleevec are allowed

- A cardiac evaluation with electrocardiogram and MUGA or echocardiogram is required
for all patients; patients must have an ejection fracture of greater than or equal to
50%

- Patients must have a serum creatinine of less than or equal to 1.2 or creatinine
clearance > 80 ml/min

- A bilirubin of less than or equal to 1.5; patients should also have an SGOT and SGPT
less than 5 times the upper limit of normal

- Pulmonary function tests including DLCO will be performed; FEV1 and DLCO should be
greater than 50% of predicted normal value

- Time from the end of last induction or reinduction attempt should be greater than or
equal to 21 days

- A signed (IRB approved) informed consent document is required; the patient, donor
family member, and transplant team (physician, nurse, and social worker) meet
together at least once prior to starting the transplant procedure to review all
pertinent risk/benefit information as part of the consenting process; alternative
treatment modalities are also discussed at this meeting

Exclusion

- Prior radiation therapy/exposure that prevents patient from receiving IMRT
(Determination will be made by the Radiation Oncologist)

- Patients who have previously undergone a blood/marrow transplant and now have
relapsed disease

- Patients with a psychological or medical condition that the treating physician deems
unacceptable to proceed to allogeneic bone marrow transplant

- Pregnancy

- EKG showing ischemic changes or abnormal rhythm and echocardiogram showing ejection
fraction < 50 % or abnormal wall motion