Melphalan and Busulfan Followed By Donor Peripheral Stem Cell Transplant, Tacrolimus, and Methotrexate in Treating Patients With Multiple Myeloma

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of multiple myeloma
• •* Stage I disease with disease progression during the second of ≥ 2 lines of prior therapy
• •* Stage II or III disease, meeting 1 of the following criteria:
• •* Failed to achieve at least a partial response after ≥ 2 courses of prior therapy
• •* Progressive disease after ≥ 2 courses of prior therapy
• •* Presented with high-risk features at diagnosis, including any of the following:
• •* Cytogenetic abnormality
• •* Del 13 or 4,14 by fluorescent in situ hybridization (FISH)
• •* Elevated lactic dehydrogenase
• •* Beta 2 microglobulin \> 5.5
• •* Circulating peripheral blood plasma cells
• •* Any stage disease with disease progression \> 6 months after prior autologous stem cell transplantation
• •Availability of an HLA-matched, related donor between 12 and 75 years of age\*
• •* No bone marrow donors NOTE: \*Donors \> 75 years of age are eligible at the discretion of the principal investigator
• •PATIENT CHARACTERISTICS:
• •Karnofsky performance status 70-100%
• •Creatinine clearance \> 60 mL/min
• •Bilirubin ≤ 2.5 mg/dL
• •ALT/AST \< 2 times upper limit of normal
• •Cardiac ejection fraction ≥ 49%
• •DLCO ≥ 50% corrected
• •FEV\_1 ≥ 60%
• •Not pregnant or nursing
• •Fertile patients must use effective contraception
• •HIV negative
• •No cirrhosis
• •No chronic inflammatory or fibrotic liver disease
• •PRIOR CONCURRENT THERAPY:
• •See Disease Characteristics
• •At least 6 months since prior autologous transplantation