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OP RESEARCH PRO00035654 NCT04071457 GANGULY ARM 1A STEP 3	

Types:      Research Oncology Treatment
Synonyms:  SWOG

Cycle 27	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Provide Lenalidomide prescription as appropriate. Follow standard of care ordering procedures in compliance with REMS. 
Lenalidomide capsules should be taken whole, with water, once daily. If a dose is missed, and it has been less than 12 hours since the preceding dose, the patient should take lenalidomide as soon as the patient remembers. If it has been more than 12 hours, the patient should skip the missed dose. 
Lenalidomide will continue at the starting dose for 3 cycles. After 3 cycles, the dose may be increased to 15 mg (at the discretion of treating physician), providing ANC GREATER than or EQUAL to 1000/mm3 and all non-hematologic toxicities have resolved to LESS than or EQUAL to Grade 1.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Provide post med prescriptions for Lenalidomide as appropriate.
1. Aspirin 81 mg by mouth once daily. Please NOTE: aspirin is not necessary if the patient is already on a DOAC, Warfarin, or LMHW.
2 . Imodium Take 2 capsules (4 mg) by mouth at the first onset of diarrhea, followed by 1 capsule (2 mg) every 2-4 hours until resolution of diarrhea. (maximum 16 mg/day). 
3. Valacyclovir 500 mg by mouth twice daily. For CrCl <10 mL/min, dose reduce to 500 mg every 24 hours
			Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 28	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 29	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 30	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 31	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 32	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 33	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 34	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 35	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 36	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 37	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 38	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 39	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
			Nursing Orders
  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	PROMIS-29 Profile v2.1. 
For the 24 month assessment using the PROMIS-29 Profile v2.1, the PROMIS-29 Profile v2.1 must be administered prior to the patient knowing their MRD status. 
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Intolerance of Uncertainty Scale - Short Form. 
For the 24 month assessment using the IUS,
the IUS will be administered after knowledge of MRD status; additionally, for MRD-negative patients, the IUS must be administered after the patient has been
notified of their randomization assignment.
			Procedures
  	BIOPSY BONE MARROW	Interval: --	Occurrences: --	Comments:	Or aspirate. Please schedule per unit protocols.
			Research Labs
☑	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Bone Marrow Aspirate (from first draw).  
Required (collect prior to Registration Step 2). 
Instructions: Overnight shipping required Lab# 233. 
For Reg Step 2 time point: Ship with diagnostic bone marrow aspirate slides. 
Instructions: Collect 2ml anticoagulated bone marrow aspirate in EDTA (lavender top) tube from the first draw at the time points listed (Note: only bone marrow aspirate may be used for the assay; blood may not be submitted in place of marrow. 
Collection Timepoint: Prior to Registration Step 2 (post transplant). 
Specimen Labeling, Packaging, and Shipping. 
Specimens must be labeled with the following information:
o Protocol number (S1803). 
o SWOG patient ID. 
o Specimen ID as generated by the SWOG Specimen Tracking System (note each specimen should have a unique specimen ID). 
o Sites NCI code. 
o Date and time of specimen collection.
		☑	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Bone Marrow Aspirate for Banking.
Bone Marrow Aspirate (from first draw) Overnight shipping required Lab# 201. Refer to: Please collect 10-20 mL bone marrow aspirate in sodium heparin (green top) tubes or (if dry tap) 60 mL peripheral blood heparin (green top) tubes
https://www.swog.org/memberresources/biospecimenresources
					
Cycle 40	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 41	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 42	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 43	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 44	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 45	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 46	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 47	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 48	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 49	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 50	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 51	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	SERUM ELECTROPHORESIS	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	URINE PROTEIN ELECTROPHORESIS, 24 HOUR	Interval: --	Occurrences: --	Comments:	UPEP response assessment must be completed for patients with measurable UPEP disease at diagnosis per Section 10.2.c. For patients that did not have
measurable disease by UPEP at diagnosis, if CR is suspected confirm with urine per Section 10.2.d. Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution
of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, SERUM	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	IMMUNOFIXATION, URINE	Interval: --	Occurrences: --	Comments:	o Perform only HMH. Otherwise, perform at Quest or LabCorp. 
o Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
		  	KAPPA LAMBDA FREE LIGHT CHAIN WITH RATIO	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
					
Cycle 52	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	Toxicity Notation
		  	ONC NURSING COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	PRO-CTCAE
		  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Lenalidomide Education and Counseling
		  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	History and Physical Exam
		  	ONC NURSING COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Weight and Performance Status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	CREATININE LEVEL	Interval: --	Occurrences: --	Comments:	Must be collected within 28 days prior to first randomization.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	TOTAL BILIRUBIN	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	AST (SGOT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
		  	ALT (SGPT)	Interval: --	Occurrences: --	Comments:	Must be collected within 42 days prior to first randomization.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Females of childbearing potential must have negative pregnancy test.
		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --	Comments:	Progression identified by SPEP, UPEP, and/or Serum FLC must be confirmed with a second disease assessment. This should be done prior to the institution of any new therapy. The second assessment can be done at any time.
			Nursing Orders
  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	PROMIS-29 Profile v2.1. 
For the 24 month assessment using the PROMIS-29 Profile v2.1, the PROMIS-29 Profile v2.1 must be administered prior to the patient knowing their MRD status. 
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Intolerance of Uncertainty Scale - Short Form. 
For the 24 month assessment using the IUS,
the IUS will be administered after knowledge of MRD status; additionally, for MRD-negative patients, the IUS must be administered after the patient has been
notified of their randomization assignment.
			Procedures
  	BIOPSY BONE MARROW	Interval: --	Occurrences: --	Comments:	Or aspirate. Please schedule per unit protocols.
			Research Labs
☑	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Bone Marrow Aspirate (from first draw).  
Required (collect prior to Registration Step 2). 
Instructions: Overnight shipping required Lab# 233. 
For Reg Step 2 time point: Ship with diagnostic bone marrow aspirate slides. 
Instructions: Collect 2ml anticoagulated bone marrow aspirate in EDTA (lavender top) tube from the first draw at the time points listed (Note: only bone marrow aspirate may be used for the assay; blood may not be submitted in place of marrow. 
Collection Timepoint: Prior to Registration Step 2 (post transplant). 
Specimen Labeling, Packaging, and Shipping. 
Specimens must be labeled with the following information:
o Protocol number (S1803). 
o SWOG patient ID. 
o Specimen ID as generated by the SWOG Specimen Tracking System (note each specimen should have a unique specimen ID). 
o Sites NCI code. 
o Date and time of specimen collection.
		☑	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Bone Marrow Aspirate for Banking.
Bone Marrow Aspirate (from first draw) Overnight shipping required Lab# 201. Refer to: Please collect 10-20 mL bone marrow aspirate in sodium heparin (green top) tubes or (if dry tap) 60 mL peripheral blood heparin (green top) tubes
https://www.swog.org/memberresources/biospecimenresources