Melphalan and Amifostine Followed By One or Two Autologous or Syngeneic Stem Cell Transplants and Maintenance Therapy in Treating Patients With Stage II-III Multiple Myeloma

Inclusion Criteria:

• Patients who have MM undergoing autologous or syngeneic hematopoietic transplantation

• Patients must meet Salmon and Durie criteria for initial diagnosis of MM

• Transplant will be offered to patients with stage II or III MM

• Measurable disease, defined as serum monoclonal protein >= 0.2 g/dl or Bence Jonesprotein >= 200 mg/24 h

• Karnofsky >= 70 or Eastern Cooperative Oncology Group (ECOG) 0-2

• Life expectancy is not severely limited by concomitant illness

• Left ventricular ejection fraction >= 50%

• No uncontrolled arrhythmias or symptomatic cardiac disease

• Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), anddiffusion capacity of carbon monoxide (DLCO) >= 50%

• No symptomatic pulmonary disease

• Human immunodeficiency virus (HIV) negative

• Bilirubin < 2 mg/dl

• Serum glutamic pyruvate transaminase (SGPT) < 2.5 x normal

• Creatinine clearance >= 60 cc/min, estimated or measured

• Signed informed consent

Exclusion Criteria:

• Pregnant or lactating females

• Uncontrolled infection

• Planned tandem autologous/reduced intensity allograft

• Insufficient PBSC for an autologous transplant (< 3.0 x 10^6 CD34+ cells/kg total)

• Prior autologous transplant

• Non-secretory myeloma and patients who are in a complete response or near completeresponse after conventional therapy

• Patients unwilling to practice adequate forms of contraception if clinically indicated

• Male patients on study need to be consulted to use latex condoms, even if they havehad a vasectomy, every time they have sex with a woman who is able to have children

• Patients with history of seizures

• Patients receiving antihypertensive therapy that cannot be stopped for 24 hourspreceding amifostine treatment