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

DISEASE CHARACTERISTICS:

• Diagnosis of multiple myeloma (MM)

  • Relapsed or refractory disease
• Monoclonal immunoglobulin spike by serum electrophoresis of ≥ 1 gm/dL AND/OR urine monoclonal immunoglobulin spike of ≥ 200 mg/24 hours
• Has received ≥ 2 prior treatment regimens for MM

• None of the following are allowed:

  • Non-secretory MM
  • Plasma cell leukemia
  • Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome

PATIENT CHARACTERISTICS:

Age

• Over 18

Performance status

• ECOG 0-2

Life expectancy

• More than 3 months

Hematopoietic

• Platelet count ≥ 50,000/mm^3 (30,000/mm^3 if the bone marrow is extensively infiltrated)
• Hemoglobin ≥ 8.0 g/dL
• Absolute neutrophil count ≥ 1,000/mm^3

Hepatic

• AST and ALT < 3.0 times upper limit of normal (ULN)
• Bilirubin < 2.0 times ULN

Renal

• Not specified

Cardiovascular

• No cardiac disease, including any of the following conditions:

  • History of recurrent supraventricular arrhythmia
  • History of sustained ventricular tachycardia
  • History of second or third degree AV block
  • History of left bundle branch block
  • Cardiomyopathy with LVEF < 40%
  • Uncontrolled ischemic heart disease
• No myocardial infarction within the past 6 months
• No prolonged QT interval > 500 ms

Other

• Not pregnant or nursing
• Negative pregnancy test
• No HIV positivity
• No neuropathy > grade 3
• Potassium ≥ 4 mEq/L
• Magnesium ≥ 1.8 mg/dL

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• Not specified

Endocrine therapy

• Not specified

Radiotherapy

• Not specified

Surgery

• Not specified

Other

• More than 30 days since prior investigational drugs