RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
so they stop growing or die. Combining chemotherapy with bone marrow transplantation may
allow the doctor to give higher doses of chemotherapy drugs and kill more cancer cells.
PURPOSE: Phase II trial to study the effectiveness of bone marrow transplantation in
treating patients with chronic lymphocytic leukemia.
OBJECTIVES: Examine the potential role for high dose cyclophosphamide, total body
irradiation and bone marrow transplantation for patients with chronic lymphocytic leukemia
who are at high risk for disease progression.
OUTLINE: Patients receive daily intravenous infusions of cyclophosphamide for two days,
followed by total body irradiation in four daily exposures. After completion of the total
body irradiation, allogeneic or autologous bone marrow is infused intravenously.
PROJECTED ACCRUAL: 50 patients are expected to be accrued.
DISEASE CHARACTERISTICS: Chronic lymphocytic leukemia (CLL) patients after initial relapse
who have achieved a complete or partial remission with fludarabine therapy or after
initial relapse or progression Prolymphocytic leukemia in first remission or after relapse
Patients 15-65 years old who lack an HLA-identical sibling are eligible for autologous BM
transplantation Patients 16-50 years old with an HLA identical or one antigen mismatched
related donor are eligible for allogeneic BM transplantation
PATIENT CHARACTERISTICS: Age: 15-65 (See Disease Characteristics) Performance status:
Zubrod no more than 2 Hematopoietic: Not specified Hepatic: Bilirubin no greater than 1.5
mg/dL Renal: Creatinine no greater than 1.5 mg/dL Cardiovascular: Cardiac ejection
fraction at least 50% Pulmonary: DLCO at least 50% of predicted Other: No severe
concomitant medical or psychiatric illnesses
PRIOR CONCURRENT THERAPY: No extensive prior radiotherapy which would prevent
administration of total body radiation Patients may also participate in study MDA-DM-92082
for retroviral gene marking of the autologous marrow and blood cells