Lenalidomide and Ipilimumab Post Allo or Auto Stem Cell Transplantation (SCT)

Study Groups:

If you agree to take part in this study, you will be assigned to a dose level of lenalidomide
based on when you join this study and whether any intolerable side effects were seen in
previous participants. Two (2) dose levels of lenalidomide will be tested. The first group of
3 participants will receive the higher dose level of lenalidomide. If intolerable side
effects are seen in the first 3 participants, the remaining participants will receive a lower
dose of lenalidomide.

All participants will receive the same dose of ipilimumab.

Study Drug Administration:

Lenalidomide On Days 1-21 of Cycles 1, 3, 5, and 7, you will take lenalidomide by mouth once
a day. You should take lenalidomide at the same time each day. You should swallow the
lenalidomide capsules whole with water. Do not open, crush, or break the lenalidomide
capsules. If you touch a broken lenalidomide capsule, wash the area of your body with soap
and water.

If you miss a dose of lenalidomide, and it has been less than 12 hours since your regular
dose time, take it as soon as you remember. If it has been more than 12 hours, just skip your
missed dose. Do not take 2 doses at the same time. If you take too much lenalidomide, call
your healthcare provider right away. If you vomit after any dose, do not take another dose.

Ipilimumab:

About 1 to 3 days after your last dose of lenalidomide in Cycles 1, 3, 5, and 7, you will
receive ipilimumab by vein over 90 minutes. About 4 weeks after each ipilimumab infusion, you
will start taking lenalidomide as described above.

You will be given a study drug diary. You will use this diary to write down what time you
take each dose of lenalidomide. You need to bring the study drug diary to every study visit
so the study staff can review it.

You will be given standard drugs to help decrease the risk of side effects. You may ask the
study staff for information about how the drugs are given and their risks.

Study Visits:

Before Cycles 1, 3, 5, and 7:

- You will have a physical exam.

- Blood (about 2 tablespoons) will be drawn for routine tests and to check your kidney and
liver function.

On about Day 14 of Cycles 1, 3, 5, and 7, blood (about 1 tablespoon) will be drawn for
routine tests.

Before Cycles 2, 4, 6, and 8:

- You will have a physical exam.

- Blood (about 2 tablespoons) will be drawn for routine tests and to check your adrenal
gland, pituitary gland, kidney, liver, and thyroid function.

- You will have an eye exam to check for side effects, if your doctor thinks it is needed.

- If you received an allogeneic stem cell transplant, you will be checked for signs of
graft-versus-host disease (GVHD). You were told about GVHD at the time of being prepared
for transplant. GVHD may cause skin rashes, diarrhea, abdominal cramping, and/or damage
to the liver, lung, eyes, mouth, skin, joints, gastrointestinal tract, and/or muscles.
It may result in jaundice (yellowing of the skin and/or eyes).

Pregnancy Tests:

If you can become pregnant, you will have pregnancy counseling and testing as long as you are
taking lenalidomide. Blood (about ½ teaspoon) or urine will be collected for a pregnancy test
at the following times:

- around 10-14 days before your first dose of lenalidomide.

- up to 24 hours before your first dose of lenalidomide during Cycles 1, 3, 5, and 7.

- one (1) time a week for the first 4 weeks that you take lenalidomide.

- one (1) time every 4 weeks during the rest of treatment if you have a regular menstrual
cycle or no cycle within 24 months, or every 2 weeks if you have an irregular menstrual
cycle.

If your periods are irregular, blood (about ½ teaspoon) will be drawn for a pregnancy test 2
weeks after your first dose of lenalidomide and again 28 days after your last dose of
lenalidomide.

Length of Study:

You may continue taking the study drugs for up to 8 cycles. You may be taken off the study
drugs early if the disease gets worse, if you have any intolerable side effects, if you are
unable to follow study directions, if your doctor thinks it is in your best interest, or if
the study is stopped.

Your participation on the study will be over after the follow-up visits.

Follow-up Visits:

After your last dose of ipilimumab, and then about 1, 3, 6, 12, 24, and 36 months later:

- You will have a physical exam.

- Blood (about 2 tablespoons) will be drawn for routine tests and to check your adrenal
gland, pituitary gland, kidney, and liver function.

- If you received an allogeneic stem cell transplant, you will be checked for signs of
GVHD.

- You will have a bone marrow aspiration and biopsy to check the status of the disease, if
your doctor thinks it is needed. To collect a bone marrow biopsy/aspirate, an area of
the hip or chest bone is numbed with anesthetic, and a small amount of bone and bone
marrow is withdrawn through a large needle.

- You will have a positron emission tomography - computed tomography (PET-CT) scan and/or
a CT scan, if your doctor thinks it is needed. A PET-CT is CT scan taken after a small
amount of radioactive glucose (sugar) is injected into a vein to find cancer cells in
the body.

If you have multiple myeloma, the following additional tests will be performed at the
follow-up visits:

- Blood (about 1-2 teaspoons) and urine will be collected to check the status of your
immune system and the disease after your last dose of ipilimumab, and then about 1, 3,
6, 12, 24, and 36 months later.

- You will have a bone marrow aspiration and biopsy at the 1-month follow-up visit or more
often, if your doctor thinks it is needed.

- You will have a bone scan to check the status of the disease at about 12, 24, and 36
months after your last dose of ipilimumab.

The above tests/procedures may be performed more often, if your doctor thinks it is needed.

• If you can become pregnant, blood (up to ½ teaspoon) will be drawn for a pregnancy test on
the following schedule:

- when you stop lenalidomide therapy and then 28 days later (if you have regular or no
menstrual cycles)

- when you stop lenalidomide therapy and then 14 and 28 days later (if you have irregular
menstrual cycles)

Inclusion Criteria:

1. Age >/= 18 years to
2. Hematologic or lymphoid malignancy.

3. Autologous patients can be included anytime within 6 months post-transplant, if they
had no signs of progression and meet one of the following criteria: i. Leukemia. ii.
Lymphoma (all types of B and T cell lymphoma). ii. Multiple myeloma.

4. Allogeneic patients if: i. Patients had engrafted donor cells (i.e., > 20% donor
T-cell from PB/PCR); and, ii. Patients NOT in CR after their allogeneic transplant,
and off tacrolimus and/or mycophenolate mofetil for at least 3 to 4 weeks with no
signs of GVHD; or, iii. Patients had evidence of relapse after their transplant who
are off tacrolimus and/or mycophenolate mofetil or other immunosuppressants for GVHD
for 3 to 4 weeks with no signs of GVHD (Prednisone doses stated previously).

5. No active infection.

6. ANC >/= 1.5 x 10^9/L; platelets > 75 x 10^9/L.

7. Able to adhere to the study visit schedule and other protocol requirements.

8. Performance status: ECOG 2 or less or Karnofsky of at least 60.

9. Cardiac EF >/= 45% by 2D-ECHO within 3 months of study entry (or within 1 month if
received chemotherapy within the past 3 months).

10. FEV1, FVC and DLCO >/= 40% within 3 months of study entry (or within 1 month if
received chemotherapy within the past 3 months).

11. Serum creatinine /= 30 ml/min. Creatinine
clearance will be calculated using the Cockcroft-Gault equation: Use actual body
weight if it is less than or equal to ideal body weight. Use ideal body weight if
patient greater than ideal body weight, but is less than or equal to 50% over ideal
body weight. Use adjusted body weight if patient is greater than 50% over ideal body
weight.

12. Liver function tests (unless related to Gilbert's disease or medications) (1) SGPT,
SGOT less than 2x the upper limit of normal range. (2) Direct Bilirubin <1.6

13. Patient or legally authorized representative able to sign informed consent.

14. 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
study entry.

Exclusion Criteria:

1. Immunotherapy or chemotherapy with approved or investigational anticancer therapeutics
within 4 weeks of first dose.

2. Patients on alemtuzumab within 6 weeks prior to consenting.

3. Active congestive heart failure (NYHA Class III to IV), symptomatic ischemia or
conduction abnormalities uncontrolled by conventional interventions. Myocardial
infarction within 6 months of study entry.

4. Deep vein thrombosis or pulmonary embolism within 3 months of study entry.

5. Pregnant or breast-feeding females. (Lactating females must agree not to breast-feed
while taking lenalidomide).

6. Acute active infection requiring intravenous antibiotics, antiviral (except antiviral
directed at hepatitis B), or antifungal agents within 14 days of first dose.

7. Known HIV seropositive, hepatitis C infection, and/or hepatitis B (except for patients
with hepatitis B Sag or core antibody receiving and responding to antiviral therapy
directed at hepatitis B: these patients are allowed).

8. Patients with other known malignancies within the past three years except: i.
Adequately treated basal or squamous cell skin cancer. ii. Carcinoma in situ of the
cervix. iii. Prostate cancer with Gleason score < 6 with stable PSA over the past
three months. iv. Breast cancer in situ with full surgical resection.

9. Significant neuropathy (grades 3 to 4 or grade 2 pain).

10. Known hypersensitivity to thalidomide, lenalidomide or ipilimumab.

11. Active life-threatening autoimmune disease.

12. Active GVHD or recent GVHD and still on > 10 mg prednisone (or equivalent).

13. Prior auto-immune disease.