Background.Pomalidomide in association with dexamethasone is approved for RRMM in 3rdline and beyond based on the multicenter international phase 3MM-003 study that demonstrated greater efficacy for Pomalidomide plus dexamethasone over high dose dexamethasone. However, MM-003 mainly recruited RRMM with 5 prior lines +, and very few data are available regarding real life Pomalidomide-based treatment in 3rdand 4thline RRMM.