Bortezomib, Lenalidomide, and Dexamethasone Combination Therapy for Patients With Relapsed or Relapsed and Refractory Multiple Myeloma

Inclusion Criteria: * Diagnosis of multiple myeloma based on standard diagnostic criteria or by the new International Myeloma Foundation 2003 Diagnostic Criteria * Relapsed or relapsed and refractory disease after receiving between 1 and 3 prior regimens * Negative serum or urine pregnancy test * Age 18 years or older * Karnofsky performance status of 60 or greater Exclusion Criteria: * Grade 2 or greater peripheral neuropathy within 14 days before enrollment * Renal insufficiency (serum creatinine \> 2.5 mg/dL) * Evidence of mucosal or internal bleeding and/or platelet refractory * ANC \< 1000 cells/mm3 * Hemoglobin \< 8.0 g/dL * AST or ALT greater than or equal to 2 x ULN * Concomitant therapy medications that include corticosteroids * Myocardial infarction within 6 months prior to enrollment or has NYHA Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities * Clinically relevant active infection or serious co-morbid medical conditions * Prior malignancy (within last 3 years) except for adequately treated basal cell or squamous cell skin cancer, in situ cervical or breast cancer, in situ prostate cancer * Pregnant or breast-feeding * Serious medical or psychiatric illness likely to interfere with participation in this clinical study. * Uncontrolled diabetes mellitus * Hypersensitivity to acyclovir or similar anti-viral drug * POEMS syndrome * Known HIV infection * Known active hepatitis B or C viral infection * Known intolerance to steroid therapy * Subjects with primary refractory disease, defined as progression during initial treatment