Randomized Trial of Lenalidomide, Bortezomib, Dexamethasone vs High-Dose Treatment With SCT in MM Patients up to Age 65

Inclusion Criteria:

Diagnosis of Multiple Myeloma, according to the International Myeloma Foundation 2003 Diagnostic Criteria
Documented symptomatic myeloma, with organ damage related to myeloma with laboratory assessments performed within 21 days of registration
Myeloma that is measurable by either serum or urine evaluation of the monoclonal component or by assay of serum free light chains.
ECOG performance status Negative HIV blood test
Voluntary written informed consent

Exclusion Criteria:

Pregnant or lactating female
Prior systemic therapy for MM (localized radiotherapy allowed if at least 7 days before study entry, corticosteroids allowed if dose Primary amyloidosis (AL) or myeloma complicated by amylosis
Receiving any other investigational agents
Known brain metastases
Poor tolerability or allergy to any of the study drugs or compounds of similar composition
Platelet count <50,000/mm3, within 21 days of registration
ANC <1,000 cells/mm3, within 21 days of registration
Hemoglobin <8 g/dL, within 21 days of registration
Hepatic impairment (>/= 1.5 x institutional ULN or AST (SGOT), ALT (SGPT), or alkaline phosphatase >2 x ULN). Patients with benign hyperbilirubinemia are eligible.
Renal insufficiency (serum creatinine >2.0 mg/dl or creatinine clearance <50 ml/min, within 21 days of registration)
Respiratory compromise (DLCO < 50%)
Clinical signs of heart or coronary failure or LVEF < 40%. Myocardial infarction within 6 months prior to enrollment, NYHA Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conductive system abnormalities
Intercurrent illness including, but not limited to ongoing or active severe infection, known infection with hepatitis B or C virus, poorly controlled diabetes, severe uncontrolled psychiatric disorder or psychiatric illness/social situations that would limit compliance with study requirements
Previous history of another malignant condition except for basal cell carcinoma and stage I cervical cancer. If malignancy was experienced more than 2 years ago and confirmed as cured, these participants may be considered for the study on case by case basis with PI discussion.
Inability to comply with an anti-thrombotic treatment regimen
Peripheral neuropathy >/= Grade 2