Acute myeloid leukemia in the elderly has a poor prognosis using standard therapy. Lenalidomide is a thalidomide analogue with activity at low doses for low-risk MDS harboring a 5q-. Two institutions using different protocols evaluated high-dose lenalidomide induction (35-50 mg daily for 14-21 days, 14-30 days of rest) followed by lower dose maintenance (10 mg daily). Out of 33 patients, four patients had a complete response.