Melphalan and Autologous Stem Cell Transplant Followed By Bortezomib and Dexamethasone in Treating Patients With Previously Untreated Systemic Amyloidosis

DISEASE CHARACTERISTICS:

Histologically confirmed amyloidosis

Diagnosed within the past 12 months

Clonal plasma cell disorder, as demonstrated by any of the following:

Presence of M-protein in serum and/or urine by immunofixation and/or serum free light chain assay
Clonal population of plasma cells in the bone marrow based on kappa/lambda staining of a marrow biopsy
Negative genetic testing for hereditary forms of amyloidosis

No amyloid-specific syndrome (e.g., carpal tunnel syndrome or skin purpura) as the only evidence of disease

Vascular amyloidosis only in a bone marrow biopsy specimen or in plasmacytoma is not indicative of systemic amyloidosis
No advanced cardiac amyloidosis

Must have symptomatic involvement of no more than 2 of the following visceral organ systems:

Kidneys
Liver/gastrointestinal
Peripheral/autonomic nervous system
Heart
No persistent pleural effusions
No clinically overt multiple myeloma with > 30% plasma cells in the bone marrow or lytic bone lesions
Able to undergo autologous stem cell transplantation

PATIENT CHARACTERISTICS:

SWOG performance status 0-3
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
Bilirubin < 2.0 mg/dL
Creatinine clearance < 51 mL/min allowed
LVEF > 45% by echocardiogram
No New York Heart Association class III-IV congestive heart failure
No history of cardiac syncope
No recurrent symptomatic arrhythmias
No oxygen-dependent restrictive cardiomyopathy
No myocardial infarction within the past 6 months
Pulmonary diffusion capacity > 50% predicted by pulmonary function testing
No uncontrolled infection

No other active malignancy, except for any of the following:

Adequately treated basal cell or squamous cell skin cancer
In situ cervical cancer
Adequately treated stage I cancer from which the patient is currently in complete remission
Any other cancer from which the patient has been disease-free for 5 years
No hypersensitivity to bortezomib, boron, or mannitol
No HIV positivity
No serious medical or psychiatric illness that would preclude study compliance

PRIOR CONCURRENT THERAPY:

At least 14 days since prior investigational drugs
No prior therapy for monoclonal plasma disease