Lenalidomide in Treating Older Patients With Acute Myeloid Leukemia Who Have Undergone Stem Cell Transplant

Inclusion Criteria:

* Patients must have a confirmed diagnosis of non-M3 AML; antecedent myelodysplastic syndrome (MDS) is acceptable
* Post autologous stem cell transplant bone marrow biopsy core that is consistent with morphologic remission
* Must have received induction and consolidation chemotherapy, and autologous stem cell transplant for AML
* Life expectancy of greater than 12 months
* Karnofsky performance status 70 or greater
* Leukocytes \>= 2,000/mcL
* Absolute neutrophil count \>= 1,000/mcL
* Platelets \>= 75,000/mcL
* Total bilirubin =\< 4 X institutional upper limit of normal unless 2nd to Gilbert's disease
* Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 4 X institutional upper limit of normal
* Creatinine \< 1.5 X institutional upper limit of normal OR creatinine clearance \>= 30 mL/min/1.73 m\^2 for patients with creatinine levels above institutional normal
* Able to take aspirin, or warfarin, or low molecular weight heparin as prophylactic anticoagulation
* Ability to understand and the willingness to sign a written informed consent document
* Must be registered into the mandatory RevAssist® program and be willing and able to comply with the requirement of RevAssist®

Exclusion Criteria:

* Patient received chemotherapy or radiotherapy within 2 weeks prior to entering the study or has not recovered from adverse events due to agents administered more than 4 weeks earlier
* Patient received another investigational agent after post autologous stem cell transplant
* Patient who will be receiving another investigational product during the study
* Patient who is growth factor or transfusion dependent
* Patient has central nervous system leukemia
* History of allergic reactions attributed to thalidomide or lenalidomide
* History of erythema nodosum, characterized by a desquamating rash while taking thalidomide or similar drugs
* Prior history of metastatic malignancy
* Uncontrolled illness including, but not limited to ongoing or active infection, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements; patients must not have suffered recent (\< 6 months) myocardial infarction, unstable angina, uncontrolled hypertension, or difficult to control cardiac arrhythmias
* Evidence of uncontrolled congestive heart failure
* Active hepatitis B as defined by hepatitis B surface antigen positivity, unless able to start dual anti-hepatitis B (HepB) therapy, or already on dual anti-HepB therapy
* Patients who are positive for hepatitis B core antibody, but negative for the hepatitis B surface antigen, should be on lamivudine 100 mg daily until at least 3 months post-transplant
* Patient is positive for human immunodeficiency virus (HIV) or human T-cell lymphotropic virus-1 (HTLV-1)
* Women of childbearing potential (defined as a sexually mature woman who has not undergone a hysterectomy or who has had menses at any time in the preceding 24 consecutive months)
* Men who did not agree not to father a child and who refused to use a latex condom during any sexual contact with women of childbearing potential while taking lenalidomide and for 4 weeks after therapy is stopped, even if they have undergone a successful vasectomy