Melphalan, Arsenic Trioxide, and Ascorbic Acid in Treating Patients With Relapsed or Refractory Multiple Myeloma

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of multiple myeloma meeting at least 1 of the following criteria:
• •Relapsed disease after a response to standard first-line chemotherapy (e.g., vincristine, doxorubicin, and dexamethasone \[VAD\] OR melphalan and prednisone) or first-line high-dose chemotherapy
• •Refractory disease (failed to achieve at least stable disease) to most recent chemotherapy with or without systemic corticosteroids
• •Measurable disease, defined as a monoclonal immunoglobulin spike on serum electrophoresis of ≥ 1 g/dL AND/OR urine monoclonal immunoglobulin spike of ≥ 200 mg/24 hours
• •No non-secretory myeloma
• •No plasma cell leukemia
• •PATIENT CHARACTERISTICS:
• •Age
• •18 and over
• •Performance status
• •Karnofsky 60-100%
• •Life expectancy
• •More than 3 months
• •Hematopoietic
• •Platelet count ≥ 50,000/mm\^3 (30,000/mm\^3 if bone marrow is extensively infiltrated)
• •Hemoglobin ≥ 8.0 g/dL
• •Absolute neutrophil count ≥ 1,000/mm\^3
• •Pancytopenia secondary to multiple myeloma or hypersplenism allowed
• •Hepatic
• •AST and ALT ≤ 3 times upper limit of normal (ULN)
• •Bilirubin ≤ 2 times ULN (unless clearly related to disease)
• •No known active hepatitis B or C infection
• •Renal
• •Calcium \< 14 mg/dL
• •Cardiovascular
• •No evidence of acute ischemia or new conduction system abnormality by electrocardiogram
• •No myocardial infarction within the past 6 months
• •No New York Heart Association class III or IV heart failure
• •No poorly controlled hypertension
• •No prolonged corrected QT interval (\> 460 ms) with potassium \> 4 mmol/L and magnesium ≥ 1.8 mmol/L
• •Other
• •No active infection
• •No POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)
• •No diabetes mellitus
• •No other serious medical or psychiatric illness that would preclude study participation
• •No known allergic reaction attributable to compounds of similar chemical or biological composition to study drugs
• •No history of grand mal seizures
• •HIV negative
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •More than 4 weeks since prior immunotherapy or antibody therapy
• •Chemotherapy
• •See Disease Characteristics
• •More than 3 weeks since prior chemotherapy (6 weeks for nitrosoureas)
• •Endocrine therapy
• •See Disease Characteristics
• •No other concurrent corticosteroids
• •Radiotherapy
• •More than 4 weeks since prior radiotherapy
• •Surgery
• •More than 4 weeks since prior major surgery
• •Other
• •No other concurrent investigational agents