ATRA, Celecoxib, and Itraconazole as Maintenance

Inclusion Criteria:

Diagnosis of relapsed multiple myeloma
Recent salvage transplant (≤ 6 months but ≥ 45 days post-transplant prior to study enrollment) for relapse
18-75 years of age at the time of study entry
Platelet count ≥70K/mm3 un-transfused
Resolution of all transplant-related toxicity to ≤ grade 2 per CTCAE v.4
Left ventricular ejection fraction as measured by ECHO or MUGA should be ≥ 40%
Creatinine of ≤ 2 mg/dl and a calculated GFR of >50mL/min/1.73m2
A total bilirubin, ALT, AST, and alkaline phosphatase of ≤ 2 ULN
Performance status of 0-2 based on the ECOG criteria. Patients with performance status 3 or 4, based solely on bone pain, are also eligible, provided that there is a source document to verify this
Prospective study participants must be informed of the investigational nature of the study and must have signed an IRB-approved informed consent form in accordance with institutional and federal guidelines

Exclusion Criteria:

Prior allogeneic transplant
Greater than grade 2 motor neuropathy or greater than grade 3 sensory neuropathy at screening
Uncontrolled diabetes
Recent (< 6 months) myocardial infarction, unstable angina, CABG or stent placement in the last 2 years, difficult-to-control congestive heart failure, uncontrolled hypertension (systolic blood pressure > 160 mm or a diastolic BP > 110 mm under normal conditions and while on appropriate anti-hypertensive medications), or difficult- to-control cardiac arrhythmias
Evidence of QT prolongation and/or torsades de pointes (TdP) on EKG.
Any co-morbid condition that poses a greater threat to the patient's life expectancy than the recurrent myeloma
No concurrent malignancy with a life expectancy of less than two years, or one that requires ongoing chemotherapeutic intervention at screening
Presence of an infection that requires intravenous antibiotics
Pregnant or nursing females. Any patient of reproductive potential may not participate unless he/she has agreed to use an effective contraceptive method as covered during the informed consent process
Known history of an HIV seropositive test