• Measure incidence of donor-derived neutrophil and platelet recovery [ Time Frame: 100 Days ] [ Designated as safety issue: Yes ]
• Measure contribution of each unit to initial and sustained engraftment [ Time Frame: 2 years ] [ Designated as safety issue: No ]
• Measure incidence and severity of acute graft-versus-host disease [ Time Frame: 100 Days ] [ Designated as safety issue: Yes ]
• Measure incidence and severity of chronic GVHD [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
• Measure incidence of transplant-related mortality [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
• Measure incidence of malignant relapse [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
• Measure incidence of serious infectious complications [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
• Measure incidence of immune reconstitution [ Time Frame: 2 years ] [ Designated as safety issue: No ]
• Measure probability of overall and disease-free survival [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

• Measure incidence of donor-derived neutrophil and platelet recovery [ Time Frame: 100 Days ]
• Measure contribution of each unit to initial and sustained engraftment [ Time Frame: 2 years ]
• Measure incidence and severity of acute graft-versus-host disease [ Time Frame: 100 Days ]
• Measure incidence and severity of chronic GVHD [ Time Frame: 1 year ]
• Measure incidence of transplant-related mortality [ Time Frame: 6 months ]
• Measure incidence of malignant relapse [ Time Frame: 2 years ]
• Measure incidence of serious infectious complications [ Time Frame: 1 year ]
• Measure incidence of immune reconstitution [ Time Frame: 2 years ]
• Measure probability of overall and disease-free survival [ Time Frame: 2 years ]

The hypothesis of the study is double unit umbilical cord blood transplantation in adults will be associated with a one year survival rate of at least 40%.

• Cord Blood Stem Cell Transplantation
• Hematologic Malignancies

Inclusion Criteria:

• Age 22 - 50 years.

• Patients will have one of the following hematological malignancies:

  • Acute myelogenous leukemia (AML):
  • Acute lymphoblastic leukemia (ALL):
  • Acute undifferentiated leukemia (AUL) or biphenotypic leukemia
  • Myelodysplastic Syndrome (MDS) with one of the following:
• Patients with adequate organ function and performance status criteria
• Two Suitable Umbilical Cord Blood Units

Exclusion Criteria:

• Patient with suitable related donor
• AML, ALL, AUL, biphenotypic leukemia beyond CR2
• AML evolved from myelofibrosis

• Any acute leukemia with:

  • Morphologic relapse or persistent disease in the BM
  • Active extra-medullary leukemia including active CNS leukemia
  • Requiring greater than two cycles of chemotherapy to obtain present remission status
• Bone marrow aplasia (defined as BM cellularity < 5% at transplant work-up)
• MDS with 10% or greater bone marrow blasts at pre-transplant workup
• Prior autologous or allogeneic HSC transplant at any time
• Prior radiation therapy rendering patient ineligible for TBI
• Any uncontrolled infection at time of study enrollment
• Seropositive or NAT positive for HIV or HTLV1
• Females who are pregnant or breast feeding
• Patient unable to give informed consent or unable to comply with the treatment protocol including appropriate supportive care, follow-up, and research tests