AML Therapy With Irradiated Allogeneic Cells

This pilot clinical trial studies if cells donated by a close genetic relative can help maintain acute myeloid leukemia (AML) complete remission (CR). Eligible patients will receive a standard induction chemotherapy. If a complete remission results they will receive irradiated allogeneic cells from a HLA haploidentical relative. Only patients who obtain a CR after the standard induction chemotherapy are eligible for the experimental therapy (irradiated haploidentical cells).

PRIMARY OBJECTIVES:

I. Toxicity of haploidentical allogeneic cellular therapy in patients in complete remission (CR) (or CR with incomplete platelet recovery \[CRp\]) after induction chemotherapy with fludarabine (fludarabine phosphate)-cytarabine.

II. Efficacy of haploidentical allogeneic cellular therapy in patients in CR (or CRp) after induction chemotherapy with fludarabine-cytarabine (remission rates at 6, 12, 18, 24 months).

SECONDARY OBJECTIVES:

I. Immunologic parameters before and after haploidentical therapy: host anti-leukemia T cells; host regulatory T cells.

OUTLINE:

INDUCTION CHEMOTHERAPY: Patients receive fludarabine phosphate intravenously (IV) over 1 hour once daily (QD) for 5 days and cytarabine IV over 4 hours for 5 days. Treatment may continue for 1 or 2 courses at the discretion of the treating physician.

ALLOGENEIC CELLULAR THERAPY: Patients undergo irradiated donor lymphocyte infusion (DLI) of 3 x 10\^8 cluster of differentiation (CD)3+ cells/kg at 8 weeks. Patients with stable disease may repeat irradiated DLI every 8-12 weeks in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up periodically for up to 2 years.

Eligibility Criteria:
Inclusion Criteria:

* Histologically proven non-M3 AML:

  * Refractory/relapsed AML OR
  * Initial diagnosis of AML in patient \>= 60 years old
* Total bilirubin =\< 1.5 times upper limit of normal (ULN) institutional limits (unless Gilbert's disease)
* Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 2.5 X institutional ULN
* Cardiac left ventricular ejection fraction (LVEF) \>= 35%
* Serum creatinine =\< 1.5 mg/dl
* Any organ dysfunction thought to be secondary to disease will be considered separately and the patient will be included at the investigators discretion
* Patients must give informed consent
* Eastern Cooperative Oncology Group (ECOG) performance status =\< 3
* Must have a potential haploidentical donor (parent, sibling, child)
* A patient is eligible for second enrollment (allo-cellular therapy) if all of the following inclusion criteria are met:
* Patient must have documented CR or CRp after 1 or 2 cycles of fludarabine + cytarabine
* Patient must not be a candidate for an allo-hematopoietic stem cell transplant (HSCT)
* Patient must have a partially (\>= 3/6 class I antigen) human leukocyte antigen (HLA)-matched (by serology or low resolution deoxyribonucleic acid \[DNA\] testing) relative able to serve as a donor
* Patients must not have active uncontrolled infections, other medical or psychological/social conditions that might increase the likelihood of patient adverse effects or poor outcomes
* Total bilirubin \< 1.5 times upper limit of normal (ULN) institutional limits (unless Gilbert's disease)
* AST(SGOT)/ALT(SGPT) =\< 2.5 X institutional ULN
* Serum creatinine \< 2.0 mg/dl
* ECOG performance status =\< 2
* DONOR: donor must be related to patient and be partially (\>= 3/6 antigen) HLA-matched
* DONOR: donor must meet all New Brunswick Affiliated Hospitals (NBAH) requirements for hematopoietic stem cell donation, including:
* DONOR: age \>= 18 years old
* DONOR: white blood cells (WBC) 4.0-10.0 x 10\^3/mm\^3
* DONOR: platelet count 150,000 to 440,000/mm\^3
* DONOR: hemoglobin/hematocrit; 12.5-18 g/dl, 38 to 54%
* DONOR: not pregnant or lactating
* DONOR: not human immunodeficiency virus (HIV)-1, HIV-2, hepatitis C virus (HCV), hepatitis B core or human T-lymphotropic virus (HTLV)-I/II seropositive; hepatitis B surface antigen (HB S ag) (-); meet other infectious disease screening criteria utilized by NBAH Blood Center
* DONOR: no uncontrolled infections, other medical or psychological/social conditions, or medications that might increase the likelihood of patient or donor adverse effects or poor outcomes
* DONOR: meet other blood bank criteria for blood product donation (as determined by NBAH Blood Center screening history and laboratory studies)

Exclusion Criteria:

* History of current or prior medical problems that the investigator feels will prevent administration of therapy or assessment of response due to excess toxicity
* Patients with known active central nervous system (CNS) leukemia will be excluded from this clinical study
* Known HIV-positive patients are excluded from the study
* Patients may not be pregnant or breast feeding