Additional Study Information: This study is being done to determine if a study drug called lenalidomide can be combined with full doses of EPOCH chemotherapy for patients with Adult T-Cell Leukemia-Lymphoma (ATLL), and to define the highest dose and longest duration of lenalidomide that can be given safely in combination with EPOCH. EPOCH chemotherapy is a combination of five chemotherapy drugs that are given over five days: etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin and has been approved by the FDA for use in patients with ATLL. The study drug, lenalidomide, in combination with EPOCH has not been approved by the FDA for any cancer. This is the first time all of these drugs will be tested together in patients with HTLV associated adult T-cell leukemia-lymphoma (ATLL). The study doctors want to find out if this approach is better or worse than the usual approach for patients with HTLV-associated adult T-cell leukemia-lymphoma. The usual approach is defined as care most people get for HTLV-associated adult T-cell leukemia-lymphoma.