The following criteria is provided for health care professionals.

Inclusion Criteria:

• Serum creatinine =< 1.5 x upper limit of normal (ULN)
• Absolute neutrophil count (ANC) >= 1700/mm^3
• Platelet count >= 100,000/mm^3
• Hemoglobin >= 8.0 g/dL
• Diagnosis of multiple myeloma according to International Myeloma Working Group criteria and one of the following:
  • Smoldering multiple myeloma (SMM)
  • Indolent multiple myeloma (IMM)
  • Newly diagnosed multiple myeloma (MM)
  • Note: patients with lytic disease and anemia are eligible
• High risk disease defined by all of the following:
  • >= 10% bone marrow plasma cells AND
  • Serum monoclonal immunoglobulin (M-protein) >= 3 g/dL OR urine M-protein >= 500 mg/24 hours (hr) AND
  • Monotypic plasma cell S-phase >= 1%
• Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2
• Provide signed informed consent
• Negative (serum or urine) pregnancy test done =< 7 days prior to registration, for women of childbearing potential only; NOTE: a second pregnancy test must be performed within 24 hours prior to the start of lenalidomide; the subject may not receive lenalidomide until the study doctor has verified that the results of these pregnancy tests are negative
• Willing to return to enrolling institution for follow-up (during the active monitoring phase of the study)

Exclusion Criteria:

• Prior treatment with any other agent that may affect M-protein =< 30 days prior to registration
• Acute/chronic infections, open wounds, or any active infection requiring intravenous antibiotic therapy =< 12 weeks prior to registration
• Other active malignancy (=< 3 years) prior to registration; exceptions: non-melanotic skin cancer or carcinoma-in-situ of the cervix or low-risk prostate cancer after curative therapy
• Any of the following:
  • Pregnant women
  • Nursing women
  • Men or women of childbearing potential who are unwilling to employ adequate contraception
• New York Heart Association (NYHA) class 3 or 4 congestive heart failure (CHF) symptoms
• Other concurrent chemotherapy, radiotherapy, or any ancillary therapy considered investigational; NOTE: bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment