Arsenic Trioxide With Ascorbic Acid and Melphalan for Myeloma Patients

Inclusion Criteria:

1. Patients with Multiple Myeloma in any of the following disease categories: a) Primary Refractory Disease b) Consolidation of a partial remission (defined as a decrease but continued presence of monoclonal protein on serum and urine immunofixation electrophoresis, and/or the presence of plasmacytosis on bone marrow aspirate and biopsy) c) All patients relapsing after prior therapy .
2. Age up to 70 years.
3. Zubrod Performance Status (PS) of \<2.
4. Left ventricular ejection fraction \>40%. No uncontrolled arrhythmias or symptomatic cardiac disease.
5. Forced vital capacity (FVC); Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and Carbon Monoxide Diffusing Capacity (DL CO) \>40%. No symptomatic pulmonary disease.
6. Serum bilirubin \<2 times upper limit of normal, SGPT \<4 times upper limit of normal. No evidence of chronic active hepatitis or cirrhosis. No effusion or ascites \>1L prior to drainage.
7. HIV-negative.
8. Patient is not pregnant.
9. Patient or guardian able to sign informed consent.
10. Corrected QT interval less than 500 msec.

Exclusion Criteria:

1. Corrected QT interval greater than 500 msec
2. Patients in complete remission (defined as the absence of monoclonal protein on serum and urine immunofixation electrophoresis, and the absence of plasmacytosis in bone marrow aspirate and biopsy).
3. Patients with non-secretory myeloma.