Samarium Sm 153 Lexidronam Pentasodium Combined With Zoledronic Acid or Pamidronate in Treating Patients With Relapsed or Refractory Multiple Myeloma and Bone Pain

DISEASE CHARACTERISTICS:

Diagnosis of multiple myeloma

Relapsed or refractory disease, meeting 1 of the following criteria:

Recurrent disease after stem cell transplantation
Recurrent or progressive disease despite treatment with ≥ 1 standard regimen (e.g., an alkylating agent plus glucocorticoid and/or the combination of vincristine, doxorubicin hydrochloride, and dexamethasone)

Measurable or evaluable disease, defined by at least 1 of the following:

Monoclonal protein ≥ 1.0 g by serum protein electrophoresis
Monoclonal protein ≥ 200 mg by 24-hour urine electrophoresis
Serum immunoglobulin free light chain ≥ 10 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio
Monoclonal bone marrow plasmacytosis ≥ 30% (evaluable disease)
Patients must have already undergone hematopoietic stem cell collection, if believed to be a transplant candidate OR not eligible for a hematopoietic stem cell transplant

PATIENT CHARACTERISTICS:

ECOG performance status (PS) 0-2 (ECOG PS 3 allowed if secondary to pain)
ANC ≥ 1,000/mm^3
Platelet count ≥ 75,000/mm^3
Hemoglobin ≥ 8.0 g/dL (transfusions allowed)
Creatinine ≤ 3 mg/dL
Calcium < 15 mg/dL
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 4 weeks after completion of study therapy
No impending long bone fracture
No active malignancy except for nonmelanoma skin cancer or carcinoma in situ of the cervix or breast
No uncontrolled infection
No other co-morbidity that would interfere with the patient's ability to participate in this trial
No known hypersensitivity to any of the components of samarium Sm 153 lexidronam pentasodium or bisphosphonates

PRIOR CONCURRENT THERAPY:

Recovered from all prior surgery, radiotherapy, or other antineoplastic therapy
More than 4 weeks since prior melphalan or other myelosuppressive agents
More than 2 weeks since prior nonmyelosuppressive agents (e.g., thalidomide or high-dose corticosteroids)
More than 30 days since prior and no other concurrent investigational therapy
No prior samarium Sm 153 lexidronam pentasodium or strontium chloride Sr 89
No concurrent external beam radiotherapy

No concurrent high-dose corticosteroids

Concurrent chronic steroids (maximum dose of 20 mg/day prednisone equivalent) allowed for disorders other than myeloma (i.e., adrenal insufficiency or rheumatoid arthritis)
Low-dose steroids allowed for replacement or inhalation therapy

No other concurrent medications, including any of the following:

Cytotoxic chemotherapy
Systemic antineoplastic therapy including, but not limited to, immunotherapy, hormonal therapy, or monoclonal antibody therapy

Prophylactic hematopoietic growth factors

Hematopoietic growth factors allowed for established cytopenia therapy