Pomalidomide for Myelofibrosis Patients

Inclusion Criteria:

1. Must be \>/= 18 years of age at the time of voluntarily signing an Institutional Review Board/Independent Ethics Committee (IRB/IEC) - approved informed consent form.
2. Must be diagnosed with myelofibrosis requiring therapy including myelofibrosis with myeloid metaplasia (MMM), de novo presentation (i.e. agnogenic myeloid metaplasia \[AMMM\], and developing after an antecedent history of Polycythemia vera (i.e., post-polycythemic myeloid metaplasia \[PPMM\]), or essential Polycythemia (i.e., post thrombocythemic myeloid metaplasia \[PTMM\]).
3. Screening total hemoglobin level \< 10 g/dL or transfusion-dependent anemia defined as per International Working Group (IWG) criteria (transfusion dependency defined by a history of a least 2 units of red blood cell transfusions in the last 28 days for hemoglobin \< 8.5 g/dL that was not associated with overt bleeding)
4. Must have adequate organ function as demonstrated by the following \</= 14 days prior to starting study drug: ·Alanine transaminase (ALT) (SGOT) and Aspartate aminotransferase (AST) (SGPT) \</= 3 x upper limit of normal (ULN), \[unless upon judgment of the treating physician, it is believed to be due to extramedullary hematopoiesis (EMH)\] ·Total bilirubin \< 3 x ULN or Direct Bilirubin \< 2 x ULN ·Serum creatinine \</= 2.5 mg/dL ·Absolute neutrophil count \>/= 1,000/µL (\>/=1.0 x 10\^9/L) ·Platelet count \>/= 50,000/µL (\>/=50 x 10\^9/L)
5. Subjects must be willing to receive transfusion of blood products
6. Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1, or 2 at screening.
7. Must be willing to adhere to the study visit schedule and other protocol requirements.
8. No active malignancies with the exception of basal cell or squamous cell carcinoma of the skin, or carcinoma (in situ) of the cervix or breast
9. 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.
10. Females of reproductive potential (FCBP†) must adhere to the scheduled pregnancy testing as required in the POMALYST REMS™ program. Able to take aspirin (81 or 325 mg) daily as prophylactic anticoagulation (patients intolerant to ASA may use warfarin or low molecular weight heparin).

Exclusion Criteria:

1. Known positive status for HIV, hepatitis B carrier, or active hepatitis C infection.
2. The use of any growth factors, cytotoxic chemotherapeutic agents (e.g. hydroxyurea), corticosteroids, or experimental drug or therapy within 14 days of starting CC-4047 and/or lack of recovery from all toxicity from previous therapy to grade 1 or better.
3. Any serious medical condition or psychiatric illness that would prevent, (as judged by the treating physician) the subject from signing the informed consent form or any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
4. Pregnant or lactating females
5. Prior use of CC-4047
6. Currently enrolled on another clinical trial or receiving investigational agent