Dexamethasone With or Without Thalidomide in Treating Patients With Newly Diagnosed Multiple Myeloma

DISEASE CHARACTERISTICS:

   - Newly diagnosed symptomatic multiple myeloma confirmed by the following:

      - Bone marrow plasmacytosis with at least 10% plasma cells or sheets of plasma
      cells or biopsy-proven plasmacytosis

      - Monoclonal protein (M protein) at least 1.0 g/dL on serum protein electrophoresis
      or at least 200 mg of monoclonal light chain on a 24-hour urine protein
      electrophoresis

   - No smoldering myeloma or monoclonal gammopathy of undetermined significance

PATIENT CHARACTERISTICS:

Age:

   - 18 and over

Performance status:

   - ECOG 0-2

Life expectancy:

   - Not specified

Hematopoietic:

   - Absolute neutrophil count greater than 1,000/mm^3

   - Platelet count greater than 50,000/mm^3

   - Hemoglobin greater than 7 g/dL

Hepatic:

   - Bilirubin no greater than 1.5 mg/dL

   - ALT and AST no greater than 2.5 times upper limit of normal

Renal:

   - Creatinine less than 3 mg/dL

Cardiovascular:

   - No prior or concurrent deep venous thrombosis

Other:

   - Prior malignancy allowed provided the following criteria are met:

      - Received prior treatment with curative intent

      - Free of disease for the time period appropriate for cure of the specific cancer

   - No grade 2 or greater peripheral neuropathy due to other medical conditions

   - No active infection

   - Not pregnant or nursing

   - Negative pregnancy test

   - Fertile patients must use 1 highly effective method and 1 additional method of
   contraception for 1 month before, during, and for 4 weeks after study for women and
   effective barrier contraception for men during and for 4 weeks after study
   participation

PRIOR CONCURRENT THERAPY:

Biologic therapy:

   - No prior biologic therapy for multiple myeloma

   - No other concurrent biologic therapy for multiple myeloma

Chemotherapy:

   - No prior chemotherapy for multiple myeloma

   - No other concurrent chemotherapy for multiple myeloma

Endocrine therapy:

   - More than 6 months since prior systemic dexamethasone or glucocorticoids

   - No concurrent corticosteroids

Radiotherapy:

   - At least 4 weeks since prior palliative, localized radiotherapy

   - Concurrent palliative, localized radiotherapy allowed at the physician's discretion

Surgery:

   - Not specified

Other:

   - No prior systemic therapy for multiple myeloma, except bisphosphonates

   - No concurrent anticoagulant therapy for deep vein thrombosis

   - No concurrent barbiturates or alcohol (thalidomide arm)