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