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    dexamethasone over 2 weeks)

   - 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