Lenalidomide, Adriamycin, Dexamethasone (RAD) Versus Lenalidomide, Bortezomib, Dexamethasone (VRD) for Induction in Newly Diagnosed Multiple Myeloma Followed by Response-adapted Consolidation and Lenalidomide Maintenance

Inclusion Criteria:

* Understand and voluntarily sign an informed consent form
* Patients willing and able to undergo autologous and allogeneic transplantation
* no previous systemic therapy for the treatment of multiple myeloma (dexamethasone at a cumulative dose of 320 mg; plasmapheresis/dialysis without concomitant chemotherapy, local irradiation of bone lesions; and surgical intervention is accepted as pretreatment)
* Newly diagnosed multiple myeloma according to common diagnostic criteria including presence of CRAB and measurable disease parameters
* Cardiac ejection fraction (LVEF) of at least 50%
* Corrected DLCO of at least 50% ; alternatively pO2 \[art.\] of at least 70mmHg
* Karnofsky performance status of greater or equal to 50%
* adequate bone marrow function
* adequate serum chemistry values
* Use of adequate contraception for female subjects with childbearing potential and male subjects
* Bone marrow sample available for analysis of molecular cytogenetics
* Able to administer low molecular-weight heparin as a prophylactic anticoagulation therapy for the first three months(applicable for subjects randomized to RAD) and able to administer ASS 100 mg/d (applicable for subjects randomized to VRD)

Exclusion Criteria:

* Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form
* Pregnant or lactating females
* Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk
* History of myocardial infarction; NYHA Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias; concomitant pericarditis or peri-/myocarditis
* Use of any other experimental drug or therapy within 28 days of baseline
* Greater or equal to Grade 2 peripheral neuropathy on clinical examination within 14 days before enrollment
* Known intolerance of boron
* Hypersensitivity to acyclovir or similar anti-viral drug
* Prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical, breast or prostate cancer
* HIV positive, active hepatitis B, C or D viral infection, known CMV reactivation/active infection, EBV reactivation/active infection or treponema pallidum infection
* Uncontrolled diabetes mellitus
* Non-secretory MM
* Clinically relevant active infection or serious co-morbid medical conditions