Bone Marrow Transplantation in Treating Patients With Multiple Myeloma, Chronic Phase Chronic Myelogenous Leukemia, or Agnogenic Myeloid Metaplasia

OBJECTIVES:

• Determine the efficacy of allogeneic bone marrow transplantation (BMT) following high-dose cyclophosphamide and total body irradiation in patients with multiple myeloma, agnogenic myeloid metaplasia, or chronic myelogenous leukemia in first or second chronic phase.
• Determine the efficacy of BMT following busulfan and cyclophosphamide in these patients.
• Determine the toxic effects of these preparative regimens in these patients.

OUTLINE: Patients are stratified by remission (first vs second vs third).

Patients who have not undergone prior radiotherapy receive cyclophosphamide IV on days -6 and -5 and then undergo total body irradiation twice a day on days -4 to -1. Allogeneic bone marrow is infused on day 0.

Patients who have undergone prior radiotherapy receive oral busulfan every 6 hours on days -7 to -4 or -6 to -3 and cyclophosphamide IV over 2 hours on days -3 and -2. Allogeneic bone marrow is infused on day 0.

Patients are followed at days 30 and 90, at 6 months, and then annually thereafter.

PROJECTED ACCRUAL: A total of 20-30 patients will be accrued for this study within 2 years.

DISEASE CHARACTERISTICS:

• Cytologically proven disease of one of the following types with transfusion-dependent anemia or thrombocytopenia (less than 50,000/mm^3):

• Multiple myeloma
• Agnogenic myeloid metaplasia
• Chronic myelogenous leukemia in first or second chronic phase

• Philadelphia chromosome with BCR gene rearrangement
• Suitable sibling bone marrow donor available

PATIENT CHARACTERISTICS:

Age:

• 15 to physiologic 55

Performance status:

• ECOG 0 or 1

Life expectancy:

• Not specified

Hematopoietic:

• See Disease Characteristics

Hepatic:

• Bilirubin no greater than 2.0 mg/dL
• SGOT less than 2 times normal
• Alkaline phosphatase less than 2 times normal

Renal:

• Creatinine less than 2 mg/dL

Cardiovascular:

• Ejection fraction normal by MUGA
• No acute myocardial infarction within the past 6 months
• No active angina pectoris
• No active congestive heart failure

Pulmonary:

• FEV greater than 50% predicted
• DLCO at least 50%

Other:

• HIV negative
• No active infection
• No concurrent organ damage or medical problems that would preclude therapy

PRIOR CONCURRENT THERAPY:

• Not specified