Arsenic Trioxide and Dexamethasone in Treating Patients With Recurrent or Refractory Stage II or Stage III Multiple Myeloma

DISEASE CHARACTERISTICS:

Diagnosis of stage II or III multiple myeloma

Refractory myeloma defined as progressive disease (more than 25% increase in M protein or in radiographic findings of nonsecretory myeloma) despite up to 3 courses of prior cytotoxic chemotherapy

No more than 3 prior cytotoxic regimens
No more than 1 prior high-dose cytotoxic regimen with stem cell transplantation
History of disease progression after prior steroid antimyeloma therapy
No smoldering myeloma
Measurable disease based on presence of serum and urine M protein and/or measurable plasmacytoma

PATIENT CHARACTERISTICS:

Age:

Over 18

Performance status:

Karnofsky 70-100%

Life expectancy:

At least 3 months

Hematopoietic:

Absolute granulocyte count greater than 1,200/mm^3*
Platelet count greater than 75,000/mm^3*
Hemoglobin greater than 10 g/dL* NOTE: *Unless due to multiple myeloma

Hepatic:

Bilirubin no greater than 2 times upper limit of normal (ULN)
SGOT and SGPT no greater than 2 times ULN

Renal:

Creatinine no greater than 1.5 times ULN

Cardiovascular:

Absolute QT interval less than 460 msec in the presence of normal potassium and magnesium levels
No significant underlying cardiac dysfunction
No conduction defects
No unstable angina
No congestive heart failure
No New York Heart Association class II-IV cardiac disease
No myocardial infarction within the past 6 months

Other:

No preexisting grade 2 or greater neurotoxicity/neuropathy
No other malignancy within the past 5 years except curatively treated carcinoma in situ of the cervix or nonmelanoma skin cancer
No uncontrolled diabetes mellitus
No active serious infection uncontrolled by antibiotics
No history of grand mal seizures (other than infantile febrile seizures)
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

See Disease Characteristics
See Chemotherapy
At least 28 days since prior biologic therapy

Chemotherapy:

See Disease Characteristics
At least 28 days since prior cytotoxic chemotherapy, including high-dose cytotoxic regimen with stem cell transplantation
No other concurrent cytotoxic chemotherapy

Endocrine therapy:

See Disease Characteristics

Radiotherapy:

At least 28 days since prior radiotherapy except for focal radiation for symptom control

Surgery:

Not specified