Clinical Research Directory

Inclusion Criteria: * Recipient must have signed a voluntary, informed consent in accordance with institutional and federal guidelines * Recipients must have histopathologically confirmed diagnosis of multiple myeloma * Age: * Stratum I (TMI containing arm): 18-60 years of age * Stratum II (non TMI arm): 18-70 years of age * Patients with primary progressive disease on induction therapy with new targeted therapies * Relapsed/refractory disease on new targeted therapies, i.e. thalidomide, lenalidomide, bortezomib, or other new novel agents such as carfilzomib, pomalidomide * Patients with relapsed multiple myeloma following previous autologous stem cell transplant * Plasma cell leukemia at diagnosis * High-risk patients with presence of chromosome 17p deletion (\> 60%) in the bone marrow by fluorescence in situ hybridization (FISH); patients are not required to have prior autologous stem cell transplant * Able to lie supine for approximately 60 minutes, the anticipated duration of each treatment session * Performance status evaluated by Eastern Cooperative Oncology Group (ECOG) or Karnofsky Performance Scales (KPS) patients must have a score of 0-II (ECOG) or \>= 70% (KPS) * Cardiac ejection fraction \>= 50% by multiple gate acquisition (MUGA) scan and/or by echocardiogram * Forced expiratory volume in one second (FEV1) \>= 50% * Diffusing lung capacity for carbon monoxide (DLCO) \>= 50% * Creatinine clearance or glomerular filtration rate (GFR) \>= 60 ml/min * Serum bilirubin =\< 2.0 mg/dl * Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) =\< 2.5 times the institutional upper limits of normal * Pre-treatment tests must be performed within 30 days prior to enrollment * No other medical and or psychosocial problems, which in the opinion of the primary physician or principal investigator would place the patient at unacceptable risk from this regimen * Patients with no previous radiation or up to a maximum 2000 cGy to non thoracic-spine and rib bone lesions or \< 20% of bone marrow are eligible for TMI conditioning regimen * Patients with previous history of irradiation at any dose to thoracic-spine, ribs or \>= 20% of bone marrow cannot undergo TMI and will be eligible for bortezomib, fludarabine, and melphalan regimen Stratum II); patients can be enrolled on stratum II at their physician's discretion or if patients decline radiation therapy DONOR: Any matched sibling donor (matched at HLA A, B, C by intermediate resolution typing and HLA-DRB1 by high resolution typing), or unmatched unrelated donor (matched at HLA A, B, C, DRB1 by high resolution typing) will be considered a suitable donor Exclusion Criteria: * Patients with peripheral neuropathy greater than grade II * Major medical or psychiatric disorders that would seriously compromise patient tolerance of this regimen * Human immunodeficiency virus (HIV) infection, active hepatitis B or C infection, or evidence of liver cirrhosis * Active viral, bacterial or fungal infection unless adequately treated. For fungal infection, patient should have completed full course of antifungal therapy with resolution of infection. * Patients with radiographic changes including pulmonary disease, including but not limited to: pulmonary nodules, infiltrates, pleural effusion are excluded unless cleared by pulmonary biopsy showing no evidence for pulmonary infection * Patients with renal insufficiency or cr clearance \< 60 ml/min DONOR: Donors will be excluded if for medical or psychological reasons they are unable to tolerate the procedure of peripheral stem cell donation