Ibrutinib, Lenalidomide, and Dexamethasone in Treating Patients With Multiple Myeloma Ineligible for Transplant

Inclusion Criteria: * Age \>= 18 years * Diagnosis * Phase I: confirmed diagnosis of relapsed or refractory multiple myeloma * Phase II: confirmed diagnosis of active multiple myeloma and must be newly diagnosed * NOTE: all tests for establishing disease status must be completed =\< 28 days prior to registration * Measurable disease =\< 28 days prior to registration, defined by at least one of the following: * Serum monoclonal protein \>= 1.0 g/dL * \> 200 mg of monoclonal protein in the urine on 24-hour electrophoresis * Serum immunoglobulin free light chain \> 10 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio * Monoclonal bone marrow plasmacytosis \> 30% (evaluable disease) * Prior treatment * Phase I: exposure to 2-3 prior lines of therapy or no therapeutic options * Phase II: previously untreated for symptomatic MM * EXCEPTION: =\< 7 days with pulse steroids or localized radiation therapy, without curative intent, for a myeloma-related complication prior to registration is allowed, as considered necessary by the treating physician * Myeloma Frailty Score: * NOTE: this will include calculating a frailty score (based on age, activities of daily living, instrumental activities of daily living and Charlson comorbidity index) * Phase I: "intermediate fitness" or "frail"; NOTE: no "fit" patients will be included in the phase 1 portion of the trial which is being done to determine the MTD of the 3-drug combination * Phase II: transplant-ineligible as per their treating physician; NOTE: all the patients with "intermediate fitness" or "frail" status will be considered transplant-ineligible; other reasons to consider transplant ineligibility may include, but are not limited to: financial constraints or patient preference; in case such patients have a frailty score of "fit", it should be duly noted by the treating physician * Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2 * Absolute neutrophil count (ANC) \>= 1,000 cell/mm\^3 without growth factor support (obtained =\< 14 days prior to registration) * Platelets \>= 50,000 cells/mm\^3 for patients who have bone marrow (obtained =\< 14 days prior to registration) * Plasmacytosis \< 50% or \>= 30,000 cells/mm\^3 for patients who have bone marrow plasmacytosis of \>= 50% (obtained =\< 14 days prior to registration) * Calculated or measured creatinine clearance \>= 30 ml/min (obtained =\< 14 days prior to registration) * Total bilirubin =\< 1.5 x upper limit of normal (ULN) unless due to Gilbert's syndrome (obtained =\< 14 days prior to registration) * Aspartate aminotransferase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) and alanine aminotransferase (ALT)/serum glutamate pyruvate transaminase (SGPT) =\< 3 x ULN (obtained =\< 14 days prior to registration) * Prothrombin time (PT)/international normalized ratio (INR) =\< 1.5 X ULN (obtained =\< 14 days prior to registration) * Provide informed written consent * Willing to return to enrolling institution for follow-up (during the active monitoring phase of the study) * Persons able to become pregnant must be willing to adhere to the scheduled pregnancy testing as required in the REVLIMID Risk Evaluation and Mitigation Strategy (REMS) program * Willing to be registered into the mandatory REVLIMID REMS program, and willing and able to comply with the requirements of the REVLIMID REMS program * Ability to complete study-related (QoL, pill diary) questionnaire(s) by themselves or with assistance * Willing to provide bone marrow aspirate and core, and blood samples for correlative research purposes Exclusion Criteria: * Non-secretory MM or known amyloid light-chain (AL) amyloidosis * Clinically significant active infection requiring intravenous antibiotics =\< 14 days prior to registration * \>= grade 3 neuropathy and/or POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes) * Other prior malignancy; EXCEPTIONS: * Adequately treated basal cell or squamous cell skin cancer * Any in situ cancer * Adequately treated stage I or II cancer from which the patient is currently in complete remission, or * Any other cancer from which the patient has been disease-free for \>= at least three years prior to registration * Concurrent therapy considered to be investigational; NOTE: patients must not be planning to receive any radiation therapy (except localized radiation for palliative care that must be completed prior to starting cycle 1, day 1) * Any of the following: * Pregnant women * Nursing women (lactating females are eligible provided that they agree not to breast feed while taking lenalidomide) * Men or women of childbearing potential who are unwilling to employ adequate contraception * Requires treatment with a strong cytochrome (CYP) 3A4/5 inhibitor * Major surgery =\< 4 weeks prior to registration * History of stroke/intracranial hemorrhage =\< 6 months prior to registration * Requires use of therapeutic anticoagulation prior to registration * NOTE: thromboprophylaxis with any agent is permitted * History of clinically significant bleeding or known platelet or coagulation disorder * Clinically significant cardiac illness including New York Heart Association (NYHA) class III or class IV heart failure, unstable angina pectoris, myocardial infarction within the past 6 months, or \>= grade 3 cardiac arrhythmias noted =\< 14 days prior to registration * Hepatic impairment: * Phase I: any currently active, clinically significant hepatic impairment (Child-Pugh class A, B, or C according to the Child Pugh classification) * Phase II: currently active, clinically significant hepatic impairment Child-Pugh class B or C according to the Child Pugh classification * Known human immunodeficiency virus (HIV) positive (+) patients; EXCEPTION: if they meet the following additional criteria =\< 28 days prior to registration: * CD4 cells \>= 500/mm\^3 * Viral load of \< 50 copies HIV messenger (m) ribonucleic acid (RNA)/mm\^3 if on combination antiretroviral therapy (cART) or \< 10,000 copies HIV mRNA if not on cART • No zidovudine or stavudine as part of cART * Known hepatitis B or hepatitis C infection; EXCEPTION: if viral load \< 800,000 IU/L * Phase I: active dermatologic disease \>= grade 3