Bortezomib, Arsenic Trioxide, and Melphalan in Treating Patients Undergoing an Autologous Stem Cell Transplant For Multiple Myeloma

DISEASE CHARACTERISTICS:

Inclusion criteria:

* Confirmed diagnosis of multiple myeloma (M-protein by serum protein electrophoresis or urine protein electrophoresis) and either bone marrow biopsy and aspirate demonstrating a plasma cell count \> 10% or biopsy of a bone or soft tissue mass demonstrating a plasmacytoma

  * Demonstration of an indication for therapy based on symptoms (e.g., boney pain), hypercalcemia, anemia, renal insufficiency, symptomatic plasmacytomas, multiple boney lytic lesions, etc
  * Stable disease or has achieved a partial remission or complete remission to pre-transplant cyto-reductive therapy
  * Primary refractory disease (no response to therapy but stable) is permitted
* Candidate for high-dose chemotherapy with autologous stem cell transplantation based on stabilization of disease with preparative chemotherapy (regardless of the specific agents)
* A minimum of 2 x 10\^6 CD34+ cells/kg must be collected prior to proceeding to transplant

Exclusion criteria:

* Evidence of active plasma cell leukemia
* Relapsed refractory disease (patients who have achieved at least a partial response \[PR\] to previous therapy and are now refractory \[have not achieved a PR to subsequent therapy\])
* Progressive disease on their last therapy

PATIENT CHARACTERISTICS:

Inclusion criteria:

* Karnofsky performance status 60-100%
* Creatinine \< 3.0 mg/dL
* AST and ALT \<2.5 times upper limit of normal
* Total bilirubin \< 3 mg/dL
* WBC ≥ 2,000/mm³
* Platelet count ≥ 50,000/mm³
* If abnormal hematologic function is attributable to bone marrow infiltration by multiple myeloma, the principal investigator will decide on a case-by-case basis if the patient's bone marrow reserve is appropriate for this study
* Females of childbearing potential must have a negative serum pregnancy test prior to enrollment on the study and must use an effective barrier method while on the study
* Ejection fraction \> 40% and no history of uncontrolled ischemic heart disease or congestive heart failure
* No evidence of cardiac amyloidosis by echocardiogram
* DLCO and FEV\_1 ≥ 50%

Exclusion criteria:

* Active peripheral neuropathy ≥ grade 2
* Recurrent supraventricular arrhythmia or any type of sustained ventricular arrhythmia or conduction block (e.g., A-V block grade II or III, left bundle branch block)
* Known HIV infection
* Pregnant or lactating women
* Underlying medical condition that could be aggravated by the treatment or life-threatening disease unrelated to myeloma as evaluated by the enrolling physician
* History of second malignancy within the past 3 years and not in complete remission from that malignancy, excluding adequately treated basal or squamous cell carcinoma of the skin, carcinoma in situ of the cervix, or local prostate cancer
* History of preexisting neurological disorders (grade 2 or higher by the NCI Common Toxicity Criteria, in particular seizure disorders)

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

* Previous radiation therapy for palliation of cord compression or pathologic fractures is permitted provided last dose is given 14 days prior to initiation of chemotherapy
* Subjects with radiographic evidence of lytic bone disease receiving concomitant bisphosphonate therapy may be enrolled

  * Bisphosphonates should be held at least 1 week prior to the transplant but continuing bisphosphonates after day +60 is at the discretion of the treating physician

Exclusion criteria:

* Previous autologous or allogeneic transplantation
* Other investigational or experimental drug or therapy while on the study