Reduced-Intensity Regimen Before Donor Bone Marrow Transplant in Treating Patients With Myelodysplastic Syndromes

Inclusion Criteria: * One of the following cytologically proven myelodysplastic syndromes * Refractory anemia (RA) * RA with ringed sideroblasts * RA with excess blasts * Chronic myelomonocytic leukemia * International Prognosis Scoring System (IPSS) score of at least 0.5 OR red cell transfusion dependence for at least 6 months (2 units per month) * Patients with an IPSS score less than 0.5 may be eligible provided they previously had a higher IPSS score and received chemotherapy at that time * Suitable human leukocyte antigen (HLA)-matched donor (related or unrelated) available * No cord blood donors * Related donors must be genotypically matched (HLA A, B and DR) at 5/6 or 6/6 loci and may be a sibling, parent, or child * Unrelated donors must have high resolution typing done at A, B, C and DR, and must be matched at all or may have a single antigen or allele mismatch at no more than one of these loci * Patients must have \< 20% blasts on bone marrow study within 1 month of study entry * Age of 18 to 70 years * Eastern Cooperative Oncology Group performance status 0-1 * Life expectancy at least 6 months * At least 90 days since prior autologous bone marrow transplantation * Serum erythropoietin level greater than 100 for patients who have not received a prior course of epoetin alfa * No iron deficiency * Iron deficiency anemia treated with iron replacement therapy allowed * Bilirubin less than 2.0 mg/dL * Alkaline phosphatase less than 2 times upper l…