Chemotherapy, Holmium Ho 166 DOTMP, and Peripheral Stem Cell Transplantation in Treating Patients With Multiple Myeloma

DISEASE CHARACTERISTICS:

Diagnosis of multiple myeloma (MM)

Patients with a prior diagnosis of monoclonal gammopathy of undetermined significance (MGUS) or smoldering myeloma are eligible if they progressed and met the criteria for diagnosis of MM
No non-secretory MM
No symptomatic MGUS, smoldering MM, or indolent MM
No solitary bone or extramedullary plasmacytoma
No immunoglobulin M myeloma
Prior treatment-for-multiple-myeloma-induction-therapy/" >induction therapy for myeloma required
Responding, stable, or progressive disease after induction therapy, or relapsed disease
Candidate for autologous hematopoietic stem cell transplantation

Prior stem cell mobilization with chemotherapy and growth factors according to institutional procedures

Availability of at least 2,000,000 CD34+ cells/kg

PATIENT CHARACTERISTICS:

Age

18 to 70

Performance status

ECOG 0-2

Life expectancy

Not specified

Hematopoietic

Not specified

Hepatic

Bilirubin no greater than 2 mg/dL
SGPT no greater than 2 times upper limit of normal
No clinical evidence of amyloidosis of the liver

Renal

Creatinine no greater than 2.0 mg/dL
Creatinine clearance at least 45 mL/min
Renal ultrasound normal
No clinical evidence of amyloidosis of the kidney
No urinary obstruction in the renal pelvis, ureter, or bladder outlet by ultrasound

Cardiovascular

Ejection fraction at least 50% with no evidence of amyloidosis by echocardiogram
No clinical evidence of amyloidosis of the heart
No uncontrolled arrhythmia
No symptomatic cardiac disease

Pulmonary

FEV1, FVC, and DLCO at least 60%
No symptomatic pulmonary disease
No clinical evidence of amyloidosis of the lungs

Other

No known allergy to vitamin C or bisphosphonates
No known hypersensitivity to technetium Tc 99m phosphorus radiopharmaceuticals (e.g., technetium Tc 99m-methylene diphosphonate)
No concurrent illness that would severely limit life expectancy
No symptoms, physical findings, or radiographic evidence of cord compression
No clinical evidence of amyloidosis of the autonomic nervous system or gastrointestinal tract
No prior noncompliance in other studies
No other malignancy within the past 5 years except treated indolent skin cancers or carcinoma in situ of the cervix
HIV negative
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

See Disease Characteristics
No prior stem cell or bone marrow transplantation
No concurrent maintenance therapy comprising interferon or thalidomide

Chemotherapy

See Disease Characteristics

Endocrine therapy

See Disease Characteristics
No concurrent maintenance therapy comprising dexamethasone

Radiotherapy

No prior cumulative external-beam radiotherapy (EBRT) to more than 20% of bone marrow
No prior cumulative EBRT dose of 30 Gy or more to the spinal cord
No prior radiotherapy to the bladder

Surgery

See Disease Characteristics

Other

At least 4 weeks since prior investigational agents for MM
At least 4 weeks since other prior experimental therapies for any other condition
No bisphosphonates for at least 4 weeks before study, during study, and for at least 30 days posttransplantation