Lenalidomide After Donor Bone Marrow Transplant in Treating Patients With High-Risk Hematologic Cancers

Inclusion Criteria:

Histologically confirmed hematologic malignancy meeting 1 of the following criteria:

High-risk acute myeloid leukemia meeting 1 the following criteria:

First complete response (CR) and ≥ 60 years of age OR < 60 years of age with high-risk cytogenetics as defined by CALGB OR high-molecular risk and not eligible or willing to undergo myeloablative conditioning
Second or later complete remission
Not in remission but with < 5% blasts within 3 weeks of start of conditioning chemotherapy for allogeneic transplantation
Patients with a history of CNS involvement allowed provided disease is in remission at the time of transplantation
Patients with non-Hodgkin lymphoma who are candidates for allogeneic stem cell transplantation will be eligible; patients who have relapsed status post autologous transplantation are eligible as long as they demonstrate chemotherapy sensitive disease; patients with a history of CNS involvement are eligible if this aspect of the disease is in remission at the time of transplantation

High-risk chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), or primary and secondary B-prolymphocytic leukemia (PLL) meeting 1 of the following criteria:

del(17p13.1) disease that has been treated (may have been given as consolidation therapy)
Less than PR to chemoimmunotherapy or relapsed within 2 years of treatment
Nucleoside analog refractory disease or disease that relapsed after two prior regimens
Patients with Richter (large cell) transformation allowed provided the large cell component of the disease is in remission (< 10% large cells in the bone marrow allowed)

Patient has undergone an allogeneic stem cell transplantation using a reduced-intensity or non-myeloablative conditioning regimen within the past 60 days

At least 40% T-cell donor chimerism at day 30
ECOG performance status 0-2 (Karnofsky 60-100%)
Life expectancy > 3 months
Myeloid engraftment with absolute neutrophil count > 1,000/μL and platelet count > 50,000/μL (after allogeneic hematopoietic stem cell transplantation [AHSCT])
Total bilirubin normal

AST and ALT ≤ 2.5 times upper limit of normal (ULN)

AST < 3 times ULN after AHSCT
Creatinine clearance ≥ 50 mL/min in stratum 1 or ≥ 30 mL/min in stratum 2
DLCO > 40% with no symptomatic pulmonary disease
LVEF ≥ 30% by echocardiogram or MUGA
Not pregnant or nursing
Negative pregnancy test
Fertile patients must agree to use two acceptable methods of contraception (one highly effective method and one additional effective method) or practice abstinence for ≥ 28 days before, during, and ≥ 28 days after completing lenalidomide
HIV negative
No uncontrolled infection requiring intravenous therapy or poorly controlled diabetes mellitus
No history of allergic reactions attributed to compounds of similar chemical or biologic composition to lenalidomide

No uncontrolled intercurrent illness including, but not limited to, any of the following:

Ongoing or active infection
Symptomatic congestive heart failure
Unstable angina pectoris
Cardiac arrhythmia
Psychiatric illness and/or social situations that would limit compliance with study requirements

No history of grade 3 or 4 graft-vs-host disease (GVHD)

If patient has acute GVHD grade 1 or 2, GVHD must be controlled and dose of oral prednisone or equivalent ≤ 20 mg per day (after AHSCT)
More than 4 weeks since prior chemotherapy (excluding steroids), radiotherapy, or radioimmunoconjugate therapy (6 weeks for nitrosoureas or mitomycin C) and recovered
No other concurrent investigational agents