• Men or women ≥ 18 and ≤ 80 years old

• Diagnosis of multiple myeloma:

‣ Serum monoclonal protein ≥ 0.5 g/dL. Patients with IgD disease and lower amounts of monoclonal protein may be permitted to enroll with PI approval

⁃ ≥ 200 mg of monoclonal protein in the urine on 24 hour electrophoresis

⁃ Serum free light chain ≥ 100 mg/L (10 mg/dL) and abnormal serum free kappa to serum free kappa light chain ratio

• Previously treated relapsed and refractory multiple myeloma

‣ Patients must have received at least one prior line of therapy;

⁃ Prior therapy must include at least 2 cycles of lenalidomide and at least 2 cycles of a proteasome inhibitor (either in separate regimens or within the same regimen)

⁃ Disease progression on or within 60 days of completion of last therapy.

• ANC ≥ 1000/μL.

‣ G-CSF is not permitted within 14 days of screening.

⁃ Patients with ANC \<1000/µL can be considered for screening on a case by case basis with additional monitoring, after discussion with and approval from the PI.

• Platelet count ≥ 50,000/µL. Platelet transfusion is not permitted within 7 days of screening.

• Hemoglobin ≥ 8 g/dL. Red blood cell transfusions are permitted to meet eligibility criteria.

• Calculated creatinine clearance of ≥ 30 mL/min by Cockcroft-Gault equation.

• Patient has adequate hepatic function, as evidenced by each of the following:

‣ Serum bilirubin values \< 2 mg/dL; and

⁃ Serum aspartate transaminase (ALT) and/or aspartate transaminase (AST) values \< 2.5 × the upper limit of normal (ULN) of the institutional laboratory reference range. Patients with elevated bilirubin due to Gilbert's syndrome may be permitted with PI approval (e.g. total bilirubin \<3 mg/dL and normal direct bilirubin).

• Must be able to take acetylsalicylic acid (ASA) daily as prophylactic anticoagulation. Patients intolerant to ASA may use low molecular weight heparin, apixaban, rivaroxaban, or equivalent.

• All study participants must be registered into the mandatory Pomalyst REMS program and be willing and able to comply with the requirements of the Pomalyst REMS program.

• Females of reproductive potential must adhere to the scheduled pregnancy testing as required in the Pomalyst REMS program.

• A man who is sexually active with a woman of childbearing potential and has not had a vasectomy must agree to use a barrier method of birth control e.g. either condom with spermicidal foam/gel/film/cream/suppository or partner with occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/suppository, and all men must also not donate sperm during the study and for 3 months after receiving the last dose of study drug.

• Able to swallow capsules whole (pomalidomide capsules cannot be crushed, dissolved or broken).