Lenalidomide After Donor Stem Cell Transplant and Bortezomib in Treating Patients With High Risk Multiple Myeloma

Inclusion Criteria:

Symptomatic multiple myeloma by International Myeloma Working Group (IMWG) criteria according to the most recent updated version (International Myeloma Workshop [IMW] meeting in Paris 2011)
Must have received at least 3 of the following classes of anti-myeloma agents either alone or in combination: glucocorticoids, immunomodulatory drugs including thalidomide, proteasome inhibitors, alkylating chemotherapy, or anthracyclines

Must meet any of these criteria for high risk disease:

Relapse or progressive disease according to uniform response criteria within 2 years after starting first-line therapy or within 2 years after autologous stem cell transplant
Failure to achieve partial response (PR) within 6 months of staring first-line therapy
Presence of high risk cytogenetic features (t(14;16), t(14;20), deletion 17p)
Chromosome 14 translocations other than to chromosome 11
Chromosome 1p deletion and 1q amplification
MyPRS gene expression score equal or higher than 45.2
High risk 70 gene expression profile (MyPRS GEP70TM)
Any other high risk genetic profile that is determined by future IMWG consensus or by internal myeloma panel consensus; for the latter, any additional criteria will be submitted as an addendum
Diagnosis with multiple myeloma between the ages of 18-50
Must have achieved at least a minor response to any previous regimen according to adapted European Group for Blood and Marrow Transplantation (EBMT) criteria
Must have suitable matched sibling or matched unrelated donor for stem cell source
Must be transplant-eligible per institution guidelines
Must have estimated glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease (MDRD) formula or Cockroft-Gault formula of 50mL/min or higher
All study participants must be registered into the mandatory Revlimid REMS® program, and be willing and able to comply with the requirements of Revlimid REMS®
Females of childbearing potential must have negative serum or urine pregnancy test and use acceptable birth control methods
Able to take aspirin daily as prophylactic anticoagulation (patients intolerant to acetylsalicylic acid [ASA] may use warfarin or low molecular weight heparin)

Exclusion Criteria:

Participants must not:

Have known hypersensitivity to thalidomide or lenalidomide
Have progressive disease at the time of transplant
Uncontrolled concurrent significant medical or psychological co-morbidity
Grade 3 peripheral neuropathy
Known seropositive for or active viral infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV); patients who are seropositive because of hepatitis B virus vaccine are eligible
Be females who are pregnant
Recent (within 3 years) history of other malignancies, excluding basal cell carcinoma or squamous cell carcinoma of the skin
Be currently enrolled in another investigational treatment protocol