The game is based on the anime, it includes scenes, pictures, and the japanese VA's (my favorite, Romi Pak beats the hell out of Vic M.). Of course, the dialogue/text is in japanese so most wont understand, but if you have watched the series, you can pretty much guess what they are talking about.
Its a pretty fun game, its mostly a side scroller (streets of rage-esqe). You can select different alchemy skills (you unlock more as you go on) and there will be the occasional(sp?) time where you need to trace/draw transmutation circles on things.
I personally liked all of the FMA games (though i guess i am sort of biased towards FMA as its one of my favorite manga/animes), but i'd definately recommend it. Its a shame that it wont get an english translation (same can be said for the 3rd RPG - damn Square-Enix).
Maybe add "dual sympathy" as an automated search on ebay. Never know when someone might put up another copy for $30