Inclusion Criteria:

          -  Patients must be diagnosed with symptomatic multiple myeloma within 90 days prior to
             registration

          -  Patients must have measurable or evaluable disease as defined by having one or more of
             the following, obtained within 35 days prior to randomization:

          -  Detectable monoclonal protein (M-protein) on serum protein electrophoresis

          -  Detectable monoclonal protein on a 24 hour urine protein electrophoresis

          -  Abnormal serum kappa to lambda free light chain ratio (< 0.26 or > 1.65)

          -  Clonal bone marrow plasma cells ≥10%

          -  Myeloma-defining bone lesion or extramedullary plasmacytoma on advanced imaging

          -  The following laboratory values must be obtained within 35 days prior to registration:

          -  Hemoglobin ≥ 7 g/dL

          -  Platelet count ≥ 50,000 cells/mm3

          -  Absolute neutrophil count ≥ 500 cells/mm3

          -  Calculated creatinine clearance ≥ 15 mL/min

          -  Bilirubin ≤ 2 mg/dL

          -  SGPT (ALT) and SGOT (AST) < 3 times the upper limit of normal. (Red blood cell and
             platelets transfusion is allowed to maintain the above goal) Patients may have
             received one cycle (28 days or less) of prior chemotherapy and no more than 320mg of
             prior dexamethasone (or equivalent dose of prednisone) for treatment of symptomatic
             myeloma. They may have received lenalidomide, bortezomib, or cyclophosphamide for
             treatment of symptomatic myeloma. They may not have received prior carfilzomib.

          -  Prior radiation therapy to symptomatic lesions is allowed provided 10 days is allowed
             between the completion of radiation therapy and start of protocol treatment.

          -  Prior systemic glucocorticoid use for the treatment of non-malignant disorders is
             permitted. Prior or concurrent topical or localized glucocorticoid therapy to treat
             non-malignant comorbid disorders is permitted.

          -  Patients must not have active, uncontrolled seizure disorder. Patients must have had
             no seizures in the last 6 months.

          -  Patients must not have uncontrolled concurrent illness including uncontrolled
             hypertension, symptomatic congestive heart failure, unstable angina, uncontrolled
             cardiac arrhythmia, uncontrolled psychiatric illness or social situation that would
             limit compliance with the study.

          -  ECOG performance status 0, 1, or 2. (PS 3 allowed if secondary to pain)

          -  Patients with monoclonal gammopathy of undetermined significance or asymptomatic
             multiple myeloma are not eligible.

          -  Patients must not have Grade 3 or higher peripheral neuropathy by CTCAE 4.0.

          -  Patients must not have active, uncontrolled infection requiring intravenous antibiotic
             therapy.

          -  Patients may have a history of current or previous deep vein thrombosis or pulmonary
             embolism but must be willing to receive anti-coagulation as prophylaxis if they are
             not currently on full-dose anticoagulation.

          -  Patients must not have New York Heart Association classification III or IV heart
             failure or myocardial infarction within the previous 6 months and must have left
             ventricular ejection fraction of at least 40%.

          -  Patients with a history of prior malignancy are eligible provided they were treated
             with curative intent and do not require active therapy (currently treated basal cell,
             squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast
             are not excluded).

          -  Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy
             test within 14 days prior starting lenalidomide and must either commit to continued
             abstinence from heterosexual intercourse or begin two acceptable methods of birth
             control, one highly effective method and one additional effective method at the same
             time, 14 days before she starts taking lenalidomide. FCBP must also agree to ongoing
             pregnancy testing. Men must agree to use a latex condom during sexual contact with a
             FCBP even if they have had a successful vasectomy. All patients must be counseled at a
             minimum of every 28 days about pregnancy precautions and risks of fetal exposure.

          -  The patient must be able to undergo advanced imaging with either WB-MRI or PET scan.

          -  The patient must not have any inherited or acquired bleeding diathesis increasing the
             risk of hemorrhage with guided biopsies.

          -  HIV infection is not excluded. Known HIV positive patients must have documented CD4
             cell count ≥ 350/mm3 and no history of AIDS-related illness.

        Exclusion Criteria:

          -  Violation of inclusion criteria specifics