Inclusion Criteria

DISEASE CHARACTERISTICS:

- Confirmed diagnosis of symptomatic multiple myeloma

- Durie Salmon stage 2 or higher

- Previously untreated multiple myeloma (including immunomodulatory drugs such as
thalidomide) with the exception of bisphosphonates

- Evaluable or measurable disease, as defined by at least one of the following:

- Serum monoclonal protein ≥ 1 g/dL (measurable disease)

- Urine monoclonal protein ≥ 200 mg/24 hours by protein electrophoresis
(measurable disease)

- Serum-free light chains (FLC) ≥ 10 mg/dL, kappa or lambda, accompanied by an
abnormal kappa/lambda ratio

Serum FLC's should only be used for patients without measurable serum or urine m-spike

- Monoclonal bone marrow plasmacytosis ≥ 30% (evaluable disease)

* Patients diagnosed with smoldering myeloma or monoclonal gammopathy of undetermined
significance are not eligible

PATIENT CHARACTERISTICS:

Inclusion criteria:

- Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0, 1, or 2

- ECOG PS of 3 will be allowed if secondary to pain in the opinion of the
Investigator

- Total bilirubin normal OR direct bilirubin ≤ 2.0 mg/dL

- Alkaline phosphatase ≤ 3 times upper limit of normal (ULN)

- AST ≤ 3 times ULN

- Creatinine ≤ 3.5 mg/dL

- Absolute neutrophil count ≥ 1,000/mm³ without transfusion or growth factor

- Platelet count ≥ 100,000/mm³ without transfusion or growth factor

- Willingness and the physical and mental capability to provide written informed
consent

- Willingness to return to Mayo Clinic Arizona/Princess Margaret Hospital for follow-up

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

Exclusion criteria:

- Peripheral sensory neuropathy ≥ grade 2 as defined by National Cancer Institute (NCI)
Common Terminology for Common Adverse Events (CTCAE) version 3.0

- Known hypersensitivity to compounds containing boron or mannitol

- Active uncontrolled infection

- Severe cardiac comorbidity including but not limited to:

- New York Heart Association class III or IV heart failure

- History of myocardial infarction within the past 6 months

- Uncontrolled angina or electrocardiographic (ECG) evidence of acute ischemia

- Severe uncontrolled ventricular arrhythmias or ECG evidence of active conduction
system abnormalities

- Cardiac amyloidosis with hypotension (i.e., systolic blood pressure < 100 mm Hg)

- Any serious medical condition, laboratory abnormality, or psychiatric illness that
would prevent study compliance or completion of study treatment

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- Prior high-dose corticosteroid therapy for 12 days or less is permitted for emergent
complications from newly diagnosed multiple myeloma

- More than 14 days since prior investigational agents

- No concurrent steroids or any other anticancer agents or treatments

- Patients may receive the equivalent of up to 20 mg prednisone per day for
concurrent illness or adrenal replacement therapy

- Concurrent palliative radiotherapy for bony pain or fracture is allowed