Lenalidomide and Melphalan in Treating Patients With Previously Untreated Multiple Myeloma

DISEASE CHARACTERISTICS:

* Histologically confirmed multiple myeloma by one of the following:

  * Biopsy of an osteolytic lesion or soft tissue tumor composed of plasma cells
  * Bone marrow aspirate and/or biopsy demonstrating ≥ 10% plasmacytosis
  * Bone marrow \< 10% plasma cells but with ≥ 1 bony lesion AND meets the M-protein criteria
* Ineligible for stem cell transplantation due to any of the following:

  * Advanced age
  * Comorbid illness
  * Patient preference
* Previously untreated disease
* Measurable (i.e., quantifiable) serum M-component of IgG, IgA, IgD, or IgE at initial diagnosis OR, if only light-chain disease is present (urine M-protein only), urinary excretion of light-chain protein (Bence Jones) ≥ 1.0 g/24 hours at initial diagnosis

  * No nonsecretory myeloma

PATIENT CHARACTERISTICS:

* ECOG performance status 0-2
* Life expectancy ≥ 12 months
* Absolute neutrophil count ≥ 1,500/mm\^3
* Platelet count ≥ 150,000/mm\^3
* Creatinine ≤ 3 times upper limit of normal (ULN)
* Bilirubin ≤ 1.5 times ULN
* AST and/or ALT ≤ 1.5 times ULN
* Alkaline phosphatase ≤ 1.5 times ULN
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use 2 methods of effective contraception during and for 4 weeks after completion of study treatment
* No other malignancies within the past 5 years, except adequately treated nonmelanoma skin cancer or curatively treated in situ cancer of the cervix
* No hypersensitivity to thalidomide or its components, including the development of a desquamating rash
* No other serious illness or medical condition that would preclude study participation
* No history of significant neurologic or psychiatric disorder that would preclude informed consent
* No known HIV positivity
* No pre-existing cardiovascular conditions and/or symptomatic cardiac dysfunction, including any of the following:

  * Significant cardiac event (including symptomatic heart failure or angina) within 3 months prior to randomization
  * Any cardiac disease that increases risk for ventricular arrhythmia
  * History of ventricular arrhythmia that was symptomatic or required treatment, including any of the following:

    * Multifocal premature ventricular contractions
    * Bigeminy
    * Trigeminy
    * Ventricular tachycardia/fibrillation/flutter/arrhythmia NOS

PRIOR CONCURRENT THERAPY:

* No prior chemotherapy or corticosteroids for the treatment of multiple myeloma

  * Prior corticosteroids for the treatment of hypercalcemia or spinal cord compression allowed provided maximum levels have not been reached (i.e.,\< 120 mg for dexamethasone or \< 792 mg for prednisone)
* Prior radiotherapy to single sites for pain control or local plasmacytoma allowed
* Prior or concurrent bisphosphonates allowed
* At least 28 days since prior investigational anticancer agents or therapy
* No concurrent corticosteroids above physiologic replacement doses
* Concurrent radiotherapy to sites of active myeloma with pain or neurologic compromise allowed
* No concurrent filgrastim (G-CSF) on day 1 of course 1
* No other concurrent anticancer therapy
* No other concurrent investigational therapy