This is a clinical trial in 278 locations to determine whether treating high-risk smoldering myeloma patients with lenalidomide is better than the "watch and wait" approach using no treatment. Results from a previous trial perfomed by a Spanish group (Dr. Mateos) showed considerable benefit in a similar study, so the study is being run in the U.S. on a large scale to accumulate more data. The study's Principal Investigator is Dr. Sagar Lonial, MD from Dana Farber and the target number of patients to join across the country is 370. More information on this trial, including study locations can be found here.