S0115, High-Dose Melphalan and Autologous Peripheral Stem Cell Transplantation in Treating Patients With Multiple Myeloma or Primary Systemic Amyloidosis

DISEASE CHARACTERISTICS: At least 1 of the following diagnoses: Multiple myeloma Stage II or III disease At least 1 of the following must be present: Serum M-protein of IgG, IgA, IgD, IgE greater than 1.0 g/dL Urinary M-protein (Bence-Jones) at least 200 mg/24 hours No IgM peaks except in patients who have physiologic criteria to support a diagnosis of multiple myeloma (e.g., bony lesions, myeloma kidney-cast nephropathy, absence of adenopathy [unless pathology-proven to be plasma cell infiltration]) No monoclonal gammopathy of undetermined significance No indolent or smoldering myeloma No disease progression on prior thalidomide or dexamethasone Histologically confirmed primary systemic amyloidosis No senile, secondary, localized, dialysis-related, or familial amyloidosis No severe cardiac involvement No pre-exertional syncope, ventricular arrhythmia, or symptomatic pleural effusions associated with cardiac involvement Light Chain Deposition Disease alone or in combination with multiple myeloma meeting the following criteria: Deposition of granular material containing free light chains/immunoglobulins that did not bind Congo red Evidence of plasma cell dyscrasia (i.e., monoclonal gammopathy in the serum or urine by immunofixation electrophoresis and/or clonal plasmacytosis) on bone marrow biopsy by immunohistochemistry and/or elevated serum-free light chain concentration Must have been diagnosed within the past year Concurrent enrollment in the myeloma repository protocol SWOG-S0309 must be offered PATIENT CHARACTERISTICS: Age 18 and over (patients with amyloidosis only OR patients with amyloidosis and multiple myeloma OR patients with multiple myeloma only with poor renal function) OR 70 and over (patients with multiple myeloma only with or without poor renal function) Performance status Zubrod 0-2 Life expectancy Not specified Hematopoietic Absolute neutrophil count at least 1,000/mm^3 Platelet count at least 100,000/mm^3 Hepatic Bilirubin no greater than 2.5 times upper limit of normal (ULN) SGOT or SGPT no greater than 2.5 times ULN Renal No hemodialysis within 2 hours of melphalan or stem cell infusion Cardiovascular See Disease Characteristics Hemodynamically stable (i.e., systolic blood pressure > 90 mm Hg in a lying position within the past 42 days) No myocardial infarction within the past 6 months No congestive heart failure No arrhythmia refractory to medical therapy LVEF greater than 45% by echocardiogram or MUGA Pulmonary See Disease Characteristics No history of chronic obstructive or chronic restrictive pulmonary disease Pulmonary function studies (e.g., FEV_1 and FVC) at least 50% of predicted DLCO at least 50% of predicted Normal high resolution CT scan of the chest and acceptable arterial blood gases (i.e., PO_2 greater than 70) required for patients unable to complete pulmonary function tests due to bone pain or fracture Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Multiple myeloma patients receiving thalidomide must use 2 methods of effective contraception for at least 4 weeks before, during, and for at least 4 weeks after discontinuation of thalidomide HIV negative No other concurrent significant medical condition No concurrent uncontrolled life-threatening infection No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated stage I or II cancer currently in complete remission PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics Chemotherapy See Disease Characteristics Prior cumulative melphalan dose no more than 200 mg No other concurrent chemotherapy Endocrine therapy See Disease Characteristics No concurrent hormonal therapy Radiotherapy No concurrent radiotherapy Surgery Not specified Other Recovered from prior therapy Prior or concurrent bisphosphonates allowed