Reduced-Intensity Conditioning Followed By Donor Peripheral Blood Stem Cell Transplant in Treating Patients With Multiple Myeloma

Exclusion Criteria

• •Karnofsky score \< 60%
• •Left ventricular ejection fraction \< 40% or symptomatic heart failure; ejection fraction is required if age \> 50 years or there is a history of anthracycline exposure or history of cardiac disease
• •Patients with clinical or laboratory evidence of liver disease would be evaluated for the cause of liver disease, its clinical severity in terms of liver function, and the degree of portal hypertension; patients will be excluded if they are found to have fulminant liver failure, cirrhosis of the liver with evidence of portal hypertension, alcoholic hepatitis, esophageal varices, a history of bleeding esophageal varices, hepatic encephalopathy, uncorrectable hepatic synthetic dysfunction evinced by prolongation of the prothrombin time, ascites related to portal hypertension, bridging fibrosis, bacterial or fungal liver abscess, biliary obstruction, chronic viral hepatitis with total serum bilirubin \> 3 mg/dL,or symptomatic biliary disease
• •Diffusion capacity of carbon monoxide (DLCO) \< 50% (corrected) or receiving continuous supplemental oxygen
• •Creatinine clearance \< 40 mL/min
• •Patients with poorly controlled hypertension
• •Seropositive for the human immunodeficiency virus (HIV)
• •Patients with a history of non-hematologic malignancies (except non-melanoma skin cancers) currently in a complete remission, who are less than 5 years from the time of complete remission, and have a \> 20% risk of disease recurrence
• •Pregnancy or breastfeeding
• •Fertile men or women unwilling to use contraceptive techniques during and for 12 months following treatment
• •Not fully recovered from previous high-dose therapy:
• •* Persistent mucositis and gastrointestinal symptoms requiring hyperalimentation and/or intravenous hydration
• •* On steroids for autologous/syngeneic GVHD
• •* On IV antibiotics for documented infections
• •* Cytomegalovirus (CMV)-antigenemia positive
• •* On ganciclovir or foscarnet for previous CMV reactivation/infection; off of this therapy for less than two weeks despite documented CMV-antigenemia- negativity (identification \[ID\] should be consulted if there is persistent CMV antigenemia post autograft)
• •* Ongoing radiotherapy
• •* Patients who meet any of these criteria may be discussed with the principal investigator for recommendations as to the timing of the allograft
• •Patients with active bacterial or fungal infections unresponsive to medical therapy
• •DONOR: Identical twin
• •DONOR: Donors unwilling to donate PBSC
• •DONOR: Pregnancy
• •DONOR: Infection with HIV
• •DONOR: Inability to achieve adequate venous access
• •DONOR: Known allergy to G-CSF
• •DONOR: Current serious systemic illness
• •DONOR: Failure to meet Fred Hutchinson Cancer Research Center (FHCRC) criteria for stem cell donation
• •DONOR: Age \< 12 years
• •DONOR: A positive anti-donor cytotoxic crossmatch is an absolute donor exclusion