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Treatment continues in the absence of disease progression or unacceptable toxicity\n\nlenalidomide: Given orally\n\ndexamethasone: Given orally\n\nDNA methylation analysis: Correlative studies\n\ngene expression analysis: Correlative studies\n\nbone marrow aspiration: Correlative studies\n\nimmunohistochemistry staining method: Correlative studies\n\nreverse transcriptase-polymerase chain reaction: Correlative studies\n\nflow cytometry: Correlative studies","id":"BG001","title":"Arm A (GFR>=60mL/Min) Dose Level 2"},{"description":"Azacitidine 30mg/m2 2x week + Lenalidomide 25mg d1-21 every 28d + Dexamethasone 40mg once a week Patients receive azacitidine subcutaneously once or twice weekly and oral dexamethasone once weekly starting on day 1. Patients also receive oral lenalidomide once daily on days 1-21. Treatment repeats every 28 days for 6 courses. Patients then continue to receive lenalidomide as maintenance therapy. Treatment continues in the absence of disease progression or unacceptable toxicity.","id":"BG002","title":"Arm A (GFR>=60mL/Min) Dose Level 3"},{"description":"Azacitidine 40mg/m2 2x week + Lenalidomide 25mg d1-21 every 28d + Dexamethasone 40mg once a week Patients receive azacitidine subcutaneously once or twice weekly and oral dexamethasone once weekly starting on day 1. Patients also receive oral lenalidomide once daily on days 1-21. Treatment repeats every 28 days for 6 courses. Patients then continue to receive lenalidomide as maintenance therapy. Treatment continues in the absence of disease progression or unacceptable toxicity.","id":"BG003","title":"Arm A (GFR>=60mL/Min) Dose Level 4"},{"description":"Azacitidine 50mg/m2 2x week + Lenalidomide 25mg d1-21 every 28d + Dexamethasone 40mg once a week Patients receive azacitidine subcutaneously once or twice weekly and oral dexamethasone once weekly starting on day 1. Patients also receive oral lenalidomide once daily on days 1-21. Treatment repeats every 28 days for 6 courses. Patients then continue to receive lenalidomide as maintenance therapy. Treatment continues in the absence of disease progression or unacceptable toxicity.","id":"BG004","title":"Arm A (GFR>=60mL/Min) Dose Level 5"},{"description":"Azacitidine 30mg/m2 2x week + Lenalidomide 10mg d1-21 every 28d + Dexamethasone 40mg once a week Patients receive azacitidine subcutaneously once or twice weekly and oral dexamethasone once weekly starting on day 1. Patients also receive oral lenalidomide once daily on days 1-21. Treatment repeats every 28 days for 6 courses. Patients then continue to receive lenalidomide as maintenance therapy. Treatment continues in the absence of disease progression or unacceptable toxicity.","id":"BG005","title":"Arm B (GFR 30-59mL/Min - CKD) Dose Level -1"},{"description":"Azacitidine 40mg/m2 2x week + Lenalidomide 10mg d1-21 every 28d + Dexamethasone 40mg once a week","id":"BG006","title":"Arm B (GFR 30-59mL/Min - CKD) Dose Level 1"},{"description":"Azacitidine 50mg/m2 2x week + Lenalidomide 10mg d1-21 every 28d + Dexamethasone 40mg once a week","id":"BG007","title":"Arm B (GFR 30-59mL/Min - CKD) Dose Level 2"},{"description":"Azacitidine 50mg/m2 2x week + Lenalidomide (10mg if CKD, 25mg if non-CKD) d1-21 every 28d + Dexamethasone 40mg once a week","id":"BG008","title":"Arm A or B GFR >= 30mL/ Min Expansion Dose (50 BIW)"},{"description":"Total of all reporting 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