Dexamethasone With or Without Thalidomide in Treating Patients With Newly Diagnosed Multiple Myeloma

DISEASE CHARACTERISTICS:

Newly diagnosed symptomatic multiple myeloma confirmed by the following:

Bone marrow plasmacytosis with at least 10% plasma cells or sheets of plasma cells or biopsy-proven plasmacytosis
Monoclonal protein (M protein) at least 1.0 g/dL on serum protein electrophoresis or at least 200 mg of monoclonal light chain on a 24-hour urine protein electrophoresis
No smoldering myeloma or monoclonal gammopathy of undetermined significance

PATIENT CHARACTERISTICS:

Age:

18 and over

Performance status:

ECOG 0-2

Life expectancy:

Not specified

Hematopoietic:

Absolute neutrophil count greater than 1,000/mm^3
Platelet count greater than 50,000/mm^3
Hemoglobin greater than 7 g/dL

Hepatic:

Bilirubin no greater than 1.5 mg/dL
ALT and AST no greater than 2.5 times upper limit of normal

Renal:

Creatinine less than 3 mg/dL

Cardiovascular:

No prior or concurrent deep venous thrombosis

Other:

Prior malignancy allowed provided the following criteria are met:

Received prior treatment with curative intent
Free of disease for the time period appropriate for cure of the specific cancer
No grade 2 or greater peripheral neuropathy due to other medical conditions
No active infection
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use 1 highly effective method and 1 additional method of contraception for 1 month before, during, and for 4 weeks after study for women and effective barrier contraception for men during and for 4 weeks after study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy:

No prior biologic therapy for multiple myeloma
No other concurrent biologic therapy for multiple myeloma

Chemotherapy:

No prior chemotherapy for multiple myeloma
No other concurrent chemotherapy for multiple myeloma

Endocrine therapy:

More than 6 months since prior systemic dexamethasone or glucocorticoids
No concurrent corticosteroids

Radiotherapy:

At least 4 weeks since prior palliative, localized radiotherapy
Concurrent palliative, localized radiotherapy allowed at the physician's discretion

Surgery:

Not specified

Other:

No prior systemic therapy for multiple myeloma, except bisphosphonates
No concurrent anticoagulant therapy for deep vein thrombosis
No concurrent barbiturates or alcohol (thalidomide arm)