A Trial of Lenalidomide & Azacitidine in Low Risk Myelodysplastic Syndromes

Eligibility criteria 1. Understand and voluntarily sign an informed consent form. 2. Age 18 years at the time of signing the informed consent form. 3. Able to adhere to the study visit schedule and other protocol requirements. 4. Diagnosis of low- or intermediate-1-risk IPSS (see Appendix III) MDS without an abnormality of chromosome 5 involving a deletion between bands q31 and q33. Pathologic diagnosis via pathology performed at Rush University Medical Center or made available to Rush from outside institution. 5. Prior treatment with \< 3 cycles (84 days) of Revlimid® (lenalidomide) are eligible for enrollment regardless of response. 6. ECOG performance status of 2 at study entry (see Appendix II). 7. Disease free of prior malignancies for \> 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "insitu" of the cervix or breast. 8. Serum bilirubin levels \< 1.5 times the upper limit of the normal range for the laboratory (ULN). Higher levels are acceptable if these can be attributed to active hemolysis or ineffective erythropoiesis. 9. Serum glutamic-oxaloacetic transaminase (SGOT) (aspartate aminotransferase \[AST\]) or serum glutamic-pyruvic transaminase (SGPT) (alanine aminotransferase \[ALT\]) levels \< 2 x ULN. 10. Serum creatinine levels \< 1.5 x ULN 11. Absolute neutrophil count \> 1000/mm³ 12. Platelet count \> 30,000/mm³ 13. All study participants must be registered into the mandatory RevAssist® program, and be willing and able to comply with the requirements of RevAssist®.