Lenalidomide Plus Bendamustine and Rituximab for Untreated CLL/SLL

• Identify the maximum tolerated dose of lenalidomide when combined with bendamustine and rituximab in CLL/SLL [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
  

• Define dose limiting toxicities of bendamustine, rituximab and lenalidomide in CLL [ Time Frame: 2 year ] [ Designated as safety issue: Yes ]
  
• Clinical efficacy [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  response rate, progression-free and overall survival
  
  

Drug: Lenalidomide
Lenalidomide will be dose escalated until the maximum tolerated dose is reached. The starting dose is 2.5mg, followed by 5mg, followed by 10mg.
Other Names:
• CC-5013
• Revlimid
Drug: Bendamustine
90 mg/m^2 IV days 1-2 of each cycle for 6 cycles
Other Names:
• Treanda
• SDX 105
Drug: Rituximab
375 mg/m^2 IV day 1 (cycle 1), 500 mg/m^2 day 1 (cycles 2-6)
Other Names:
• Rituxan
• Mabthera

Subjects will receive lenalidomide, bendamustine and rituximab in cycles of 28 days (4 weeks). Lenalidomide will be administered orally once daily on days 8-21 of cycle 1 and on days 1-21 of all subsequent cycles. Bendamustine will be administered through a vein (IV infusion) on days 1 and 2 of each cycle. Rituximab will be administered as an IV infusion on day 1 of each cycle.

Subjects will receive routine blood tests and physical exam during each cycle. Tumor assessments by CT scan will be performed during cycles 2, 4, and 6.