Lenalidomide (Revlimid®) Plus Low-dose Dexamethasone (Ld x 4 Cycles) Then Stem Cell Collection Followed by Randomization to Continued Ld or Stem Cell Transplantation (SCT) Plus Maintenance L

Inclusion Criteria:

- Age ≥ 18 and ≤ 75

- Histologic and serologic findings from MSKCC confirming the diagnosis of multiple
myeloma. Standard diagnostic criteria for multiple myeloma will be used, as per the
revised International Myeloma Working Group diagnostic criteria.

- Patients must have symptomatic multiple myeloma without advanced organ damage (such as
multiple fractures or advanced bone disease causing immobilization, renal failure,
spinal cord compression, or organ compromise due to soft tissue plasmacytoma). If
immediate therapy with radiation and high-dose steroids (eg, for cord compression) or
with bortezomib-based therapy (eg, for renal failure) is required, the patient is not
eligible for this trial.

- Patients may have received 1 cycle of prior therapy with dexamethasone for multiple
myeloma.

- Adequate organ function is required, defined as follows:

- ANC ≥ 1,500/μl and platelets ≥ 100,000/μl (unless low ANC and platelets are due to
multiple myeloma)

- Serum bilirubin ≤ 2.0 mg/dl

- AST, ALT and alkaline phosphatase < 3 times the upper limit of laboratory normal

- Adequate renal function as assessed by calculated creatinine using Cockcroft-Gault
estimation of CrCl (see Appendix I): Subjects must have calculated creatinine
clearance ≥ 30ml/min by Cockcroft-Gault formula

- Performance status (ECOG) ≤ 2 (Appendix E).

- Eligible for SCT with LVEF ≥ 50% by MUGA or ECHO, and diffusing capacity > 50%
predicted by pulmonary function testing

- Ability to understand the investigational nature of this study and to give informed
consent

- All study participants must be registered into the mandatory Revlimid REMS® program,
and be willing and able to comply with the requirements the of Revlimid REMS® program

- Females of childbearing potential (FCBP)† must have a negative serum or urine
pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior to
and again within 24 hours prior to prescribing lenalidomide for cycle 1 (prescriptions
must be filled within 7 days) and must either commit to continued abstinence from
heterosexual intercourse or begin TWO acceptable methods of birth control, one highly
effective method and one additional effective method AT THE SAME TIME, at least 28
days before she starts taking lenalidomide. FCBP must also agree to ongoing pregnancy
testing. Men must agree not to father a child and agree to use a latex condom during
sexual contact with females of child bearing potential even if they have had a
successful vasectomy. See Appendix C: Risks of Fetal Exposure, Pregnancy Testing
Guidelines and Acceptable Birth Control Methods.

- Able to take aspirin 325mg or 81mg daily as prophylactic anticoagulation (patients
intolerant to ASA may use Coumadin or low molecular weight heparin).

Exclusion Criteria:

- Prior treatment for myeloma except for one cycle of dexamethasone

- History of thromboembolic disease within the past 6 months regardless of
anticoagulation

- Myocardial infarction within 6 months prior to enrollment, or New York Hospital
Association (NYHA) Class III or IV heart failure (see APPENDIX F), uncontrolled
angina, severe uncontrolled ventricular arrhythmias, electrocardiographic evidence of
acute ischemia or active conduction system abnormalities.

- Pregnant or breast-feeding women are excluded due to the potential teratogenicity of
lenalidomide.

- Concurrent active malignancy other than non-melanoma skin cancers or carcinoma-insitu
of the cervix, or presence of myelodysplastic or myeloproliferative disease. Patients
with prior malignancies with a disease-free interval of ≥ 5 years are eligible.

- Patients who have had prior malignancies within the past 5 years but are considered to
be "cured" with a low likelihood of recurrence may be eligible at the discretion of
the Principal Investigator.

- Active hepatitis B or C infection

- HIV 1 or 2 positivity

- Any other medical condition or laboratory evaluation that, in the treating physician's
or principal investigator's opinion, makes the patient unsuitable to participate in
this clinical trial