Amifostine and Melphalan in Treating Patients With Primary Systemic Amyloidosis Who Are Undergoing Peripheral Stem Cell Transplantation

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed amyloidosis
• •* No secondary familial or localized amyloidosis
• •Presence of monoclonal protein by immunoelectrophoresis or immunofixation of serum or urine
• •No primary amyloidosis manifested only by carpal tunnel syndrome or purpura
• •Amyloid deposits in a plasmacytoma or in bone marrow vessels in an asymptomatic individual not considered an amyloid syndrome
• •* Amyloid syndromes include any of the following:
• •* Hepatomegaly
• •* Cardiomyopathy
• •* Nephrotic range proteinuria
• •* Peripheral or autonomic neuropathy
• •No multiple myeloma defined by 1 of the following:
• •* Presence of lytic bone disease
• •* More than 30% bone marrow plasma cells
• •PATIENT CHARACTERISTICS:
• •Age
• •18 to 70
• •Performance status
• •ECOG 0-1
• •Life expectancy
• •Not specified
• •Hematopoietic
• •Platelet count at least 100,000/mm\^3
• •Hepatic
• •See Disease Characteristics
• •Total or direct bilirubin no greater than 2.0 mg/dL
• •Alkaline phosphatase no greater than 4 times upper limit of normal
• •Renal
• •See Disease Characteristics
• •Creatinine less than 3.0 mg/dL
• •Cardiovascular
• •See Disease Characteristics
• •Ejection fraction at least 45% by echocardiogram
• •No New York Heart Association class III or IV heart disease
• •Systolic blood pressure ≥ 90 mmHg
• •Other
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •No active infection
• •No other malignancy within the past 5 years except surgically treated carcinoma in situ of the cervix, nonmelanoma skin cancer, or indolent prostate cancer
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •At least 4 weeks since prior interferon
• •Chemotherapy
• •At least 4 weeks since prior melphalan
• •Lifetime total melphalan dose less than 150 mg/m\^2 (based on ideal body weight)
• •Endocrine therapy
• •At least 4 weeks since prior dexamethasone
• •Radiotherapy
• •No prior radiotherapy for amyloidosis
• •Surgery
• •Not specified
• •Other
• •No antihypertensive medications for at least 24 hours prior to, during, and for 1 hour after amifostine administration
• •No other prior treatment