High-Dose Melphalan Followed by Peripheral Stem Cell Transplant in Treating Patients With Amyloidosis

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Primary amyloidosis diagnosed by appropriate amyloid stains or electromicroscopy of abdominal fat, bone marrow, or other target tissues
• •* Pathology reviewed by Temple University
• •Amyloidosis secondary to any stage of multiple myeloma allowed provided plasma cell concentration in bone marrow is less than 15%
• •No amyloidosis secondary to rheumatoid arthritis or chronic infection
• •No familial amyloidosis
• •PATIENT CHARACTERISTICS:
• •Age:
• •16 to 65
• •Performance status:
• •Karnofsky 80-100%
• •Hematopoietic:
• •Not specified
• •Hepatic:
• •Liver function tests less than twice normal
• •No active liver disease
• •Renal:
• •Creatinine clearance greater than 50 mL/min
• •Nephrotic syndrome allowed
• •Cardiovascular:
• •Cardiac evaluation required in patients with left ventricular ejection fraction less than 45% by echocardiogram or MUGA
• •No poorly controlled hypertension
• •Pulmonary:
• •FEV\_1 and DLCO greater than 50% of predicted, or pulmonary evaluation required
• •No chronic obstructive pulmonary disease
• •Other:
• •No history of serious coagulopathy, hemorrhage, or bleeding
• •No active infection
• •No other serious comorbid disease (e.g., poorly controlled diabetes)
• •No pregnant women
• •Adequate contraception required of fertile women
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •Not specified
• •Chemotherapy:
• •More than 12 monthly cycles of prior alkylating agent chemotherapy discouraged
• •Endocrine therapy:
• •Corticosteroids discontinued at least 6 weeks prior to transplantation
• •Radiotherapy:
• •No prior radiotherapy
• •Surgery:
• •Not specified