Lenalidomide in Anti-MAG Neuropathy: Phase 1b Study

Inclusion Criteria: * • Patients must have an Anti-Myelin Associated Glycoprotein titer * Patients must have Distal acquired demyelinating sensorimotor (DADS) peripheral neuropathy phenotype as defined per European Federation of Neurological Societies (EFNS) demyelinating criteria with preferential distal nerve involvement, as captured per terminal latency index \[terminal distance/(conduction velocity x terminal latency)\], in the setting of a monoclonal gammopathy * Patients must be at least 18 years of age with no evidence of multiple myeloma, light chain amyloidosis or other hematologic disorder requiring treatment. * Patient may be enrolled at any time from last line of therapy. * Patients must have ANC \> 1000/µL and Platelets ≥75,000/µL * Patients must have adequate hepatic function as evidenced by: total bilirubin \< 1.5 mg/dL, alkaline phosphatase \< 3X the ULN, and AST/ALT \< 2X the ULN. * Patients must be able to take any of the following once lenalidomide starts and for at least 5 days after last dose lenalidomide: 1) 81-325 mg of coated aspirin daily; 2) full dose warfarin (target INR 2-3); 3) 2.5 mg or above of apixaban twice daily; 4) low molecular weight heparin; 5) 20 mg or above of rivaroxaban daily. * Patients must have adequate renal function as evidenced by serum creatinine \< 2mg/dL or calculated creatinine clearance of ≥ 40ml/min within 14 days of registration using MDRD formula. * Patient must be able to swallow capsule or tablet. *…