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OP RESEARCH PRO00038188 NCT06208150 ARM C EPD	

Types:      Research Oncology Treatment
Synonyms:  

Cycle 1	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	72 hrs prior to first dose of study treatment on C1D1
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	72 hrs prior to first dose of study treatment on C1D1
		  	LDH	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	URIC ACID LEVEL	Interval: --	Occurrences: --	Comments:	May be performed within 72 hrs before dosing, including for C1D1.
			Labs
  	HEMOGLOBIN A1C	Interval: --	Occurrences: --			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pre-dose.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pre-dose.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pre-dose.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	ONC NURSING COMMUNICATION 60	Interval: --	Occurrences: --	Comments:	First infusion (Cycle 1, Dose 1): Infuse at 0.5 mL/minute for the first 30 minutes. If no infusion reactions occur, may increase the rate to 1 mL/minute for the next 30 minutes. If tolerated, may then increase the rate to 2 mL/minute until infusion completion (maximum rate: 2 mL/minute).
		  	elotuzumab (EMPLICITI) 10 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 10 mg/kg	Route: intravenous	once for 1 dose			Offset: 90 Minutes	Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
First infusion (Cycle 1, Dose 1): Infuse at 0.5 mL/minute for the first 30 minutes. If no infusion reactions occur, may increase the rate to 1 mL/minute for the next 30 minutes. If tolerated, may then increase the rate to 2 mL/minute until infusion completion (maximum rate: 2 mL/minute).
	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	10 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 8	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	If no infusion reactions occurred during the prior infusion, initiate at 3 mL/minute for the first 30 minutes. If tolerated, may then increase the rate to 4 mL/minute until infusion completion (maximum rate: 4 mL/minute).
		  	elotuzumab (EMPLICITI) 10 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 10 mg/kg	Route: intravenous	once for 1 dose			Offset: 90 Minutes	Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
If no infusion reactions occurred during the prior infusion, initiate at 3 mL/minute for the first 30 minutes. If tolerated, may then increase the rate to 4 mL/minute until infusion completion (maximum rate: 4 mL/minute).

	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	10 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Days 15,22	Perform every 7 days x2			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	ONC NURSING COMMUNICATION 63	Interval: --	Occurrences: --	Comments:	Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).
		  	elotuzumab (EMPLICITI) 10 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 10 mg/kg	Route: intravenous	once for 1 dose			Offset: 90 Minutes	Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).

	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	10 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 2	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 10 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 10 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	10 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Days 8,15,22	Perform every 7 days x3			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 10 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 10 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	10 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 3	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 4	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 5	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEMOGLOBIN A1C	Interval: --	Occurrences: --			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pre-dose.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pre-dose.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 6	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 7	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 8	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 9	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEMOGLOBIN A1C	Interval: --	Occurrences: --			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 10	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycles 11,12	Repeat 2 times	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 13	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 35	Interval: --	Occurrences: --	Comments:	OPTIONAL qualitative interview: 12 months (±3 months) after the start of study treatment.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEMOGLOBIN A1C	Interval: --	Occurrences: --			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 14	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 15	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 16	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 17	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEMOGLOBIN A1C	Interval: --	Occurrences: --			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 18	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 19	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 20	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 21	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEMOGLOBIN A1C	Interval: --	Occurrences: --			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 22	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 23	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 24	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be collected on Day 1 of C1 to C12, then on Day 1 of every 3rd cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 25	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	Physical examination: Symptom and disease related. Physical examination to be done once per cycle. Assessment of soft-tissue plasmacytomas by physical examination (if applicable) Q28d (±7d) from C1D1.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Nursing Orders
  	ONC NURSING COMMUNICATION 34	Interval: --	Occurrences: --	Comments:	Venous thromboembolism prophylaxis as clinically indicated 
			Imaging
◉	TRANSTHORACIC ECHOCARDIOGRAM COMPLETE W CONT STRAIN 3D IF NEEDED	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
		◯	NM RADIONUCLIDE ANGIOGRAPHY (MUGA) RESTING ONLY	Interval: --	Occurrences: --	Comments:	TTE (ECHO) or MUGA scan
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HEMOGLOBIN A1C	Interval: --	Occurrences: --			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose.
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HBV infection. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Patients with history of HCV antibody positivity. to be done (±7 days), every 12 weeks (±4 weeks) up to 6 months after last dose.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD. 
3. Time of PD.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
			Pre-Medications
  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. 		  	famotidine (PEPCID) tablet 20 mg	Dose: 20 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.		  	dexAMETHasone (DECADRON) tablet 8 mg	Dose: 8 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 45-90 min before elotuzumab. If IV is desired, place order as appropriate.			Chemotherapy
  	ONC NURSING COMMUNICATION 53	Interval: --	Occurrences: --	Comments:	Confirm that patient is taking Dexamethasone and Pomalidomide appropriately. 
Dexamethasone: 
For patients LESS than or EQUAL to 75 years of age. Give 28 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 28 mg on Day 1 of Cycle 3. Give 40 mg on Days 8, 15, and 22 of Cycle 3+.
For patients GREATER than 75 years of age. Give 8 mg on Days  1, 8, 15, 22 of Cycle 1 and 2. Give 8 mg on Day 1 of Cycle 3. Give 20 mg on Days 8, 15, and 22 of Cycle 3+. 
Pomalidomide: 4 mg/day on Days 1-21 of each cycle. There must be GREATER than or EUQAL to 7 days between the course of pomalidomide for each cycle.
		  	elotuzumab (EMPLICITI) 20 mg/kg in sodium chloride 0.9% 230 mL IVPB	Dose: 20 mg/kg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Protect from light.  Administer with low protein binding 0.22 micron filter.
o Subsequent infusions (Cycle 1, Doses 3 and 4 and all subsequent infusions): If no infusion reactions occurred during the prior infusion, initiate and infuse at 5 mL/minute until completion (maximum rate: 5 mL/minute).	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ELOTUZUMAB 300 MG/12 ML INTRAVENOUS SOLUTION (RECONSTITUTED VIAL)	Medications	20 mg/kg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	230 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
EOT (</= 30d after last dose)	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	ECOG performance status
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	MRU: Collected continuously after first day of study treatment until PD or 30d after last dose or the SST, whichever is earlier.
		  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	Symptomatic progression evaluation: From 30d prior, to until 30d after confirmed PD (or the start of SST, whichever is earlier).
		  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant therapy: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinical indicated
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LDH	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	LIPASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	AMYLASE LEVEL	Interval: --	Occurrences: --	Comments:	From C1D8 may be performed within 48 h before dosing.
		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	IF congenital nonhemolytic hyperbilirubinemia. 
From C1D8 may be performed within 48 h before dosing.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	FIBRINOGEN	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	Patients with history of HIV antibody positivity and every 4th cycles thereafter during treatment, and at EOT, 3 and 6 months after last dose.
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Perform PCR testing Q12W (±4 weeks) up to 6 months after last dose of study treatment for participants with history of HBV infection/HCV antibody positivity.
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Perform PCR testing Q12W (±4 weeks) up to 6 months after last dose of study treatment for participants with history of HBV infection/HCV antibody positivity.
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Serum pregnancy test within 10-14d prior to C1D1 Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Serum or urine pregnancy test within 24 h prior to C1D1. 
Within 24 h of D1 of each cycle. 
Weekly for the first 4 weeks of pomalidomide treatment, including within 24 h prior to start of pomalidomide administration. 
Thereafter, Q28d (or Q14d for participants with irregular menses).
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
For participants with measurable disease only by light chain: with every disease evaluation and, if applicable, each pre-PD disease evaluation visit until PD or 30 d after the start of SST. 
Serum FLC
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory . Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. For participants with measurable disease by serum and/or urine M spike: at time of suspected CR or sCR
			Provider Communication
  	ONC PROVIDER COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Bone marrow aspirate: For local assessments; see Section 8.2.6 (a portion of aspirate should be sent to the central laboratory for biomarker and MRD analysis). 
1. Whenever CR or sCR are suspected. 
2. For participants with confirmed CR or sCR, collect additional samples 12 months post C1D1 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, then every 12 months (±3 months) until PD. 
3. Time of PD (even if occurs after treatment is discontinued; should occur prior to SST).
		  	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Skeletal survey: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Include imaging of skull, entire vertebral column, pelvis, chest, humeri, femora, and any other anatomical regions for which involvement by disease is suspected.
		  	ONC PROVIDER COMMUNICATION 6	Interval: --	Occurrences: --	Comments:	Low dose whole body CT: As clinically indicated to document response or disease progression before start of SST. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 7	Interval: --	Occurrences: --	Comments:	Whole body DWI-MRI -
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants. 
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
		  	ONC PROVIDER COMMUNICATION 8	Interval: --	Occurrences: --	Comments:	PET/CT with diagnostic CT component - 
1. For lytic bone lesions assessment, perform as clinically indicated to document response or disease progression before start of SST. 
2. For participants with a history of soft-tissue plasmacytoma until development of confirmed CR, PD or start of SST. For assessment by radiology, perform Q12W(±7d) from C1D1. 
3. As clinically indicated for other participants.  
Imaging modality acceptable for disease evaluation and assessment of lytic bone lesions and soft tissue plasmacytoma. 
Should include the vertex of the skull and the knees. If institutional protocols are available, the lower extremities should be shown in full.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pre-dose.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Response-based - 
1. Time of suspected CR or sCR. 
2. For participants with confirmed CR or sCR, additional samples will be collected 6 (±3 months) and 12 months (±3 months) after time of confirmed CR or sCR, and then every 12 months (±3 months) until PD.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pre-dose.
			Provider Communication
  	ONC PROVIDER COMMUNICATION 9	Interval: --	Occurrences: --	Comments:	Biopsy of soft-tissue plasmacytomas as clinically indicated. See section 8.2.5. Order as appropriate.
					
Pre-PD Q28D	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be done every 16 weeks ±14 days during Follow-up Phase' (PRE-PD)
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant medications: continuous from signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS
		  	ONC NURSING COMMUNICATION 36	Interval: --	Occurrences: --	Comments:	SST
		  	ONC NURSING COMMUNICATION 37	Interval: --	Occurrences: --	Comments:	Survival: Every 16 weeks
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Until 6 months after last dose
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Arm A (Tal-P) only: Weekly for first 4 weeks from start of Pomalidomide administration. Thereafter Q28d (Q14d for those with irregular menses).
Serum or urine pregnancy test within 24 h prior to C1D1, at EOT and per local standards until 6 months after last dose.
			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	To be done 3 and 6 months (±1 month) after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	To be done 3 and 6 months (±1 month) after last dose
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Perform PCR testing Q12W (±4 weeks) up to 6 months after last dose of study treatment for participants with history of HBV infection/HCV antibody positivity.
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Perform PCR testing Q12W (±4 weeks) up to 6 months after last dose of study treatment for participants with history of HBV infection/HCV antibody positivity.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD
					
Post-PD Q16W	Repeat 1 time	Cycle length: 112 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration:   MMY3009_Ganguly
		  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Treatment Drugs: Refer to Section 6.6: 
Protocol Access Hyperlink   MMY3009_Ganguly 
			Nursing Orders
  	ONC NURSING COMMUNICATION 25	Interval: --	Occurrences: --	Comments:	PRO data collection: MySIm-Q, EORTC-QLQC30, EQ-5D-5L, PGI-S, Epstein Taste Survey to be done every 16 weeks ±14 days during Follow-up Phase' (PRE-PD)
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Adverse events: From signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report any AEs/SAEs related to study treatment until EOS.
		  	ONC NURSING COMMUNICATION 33	Interval: --	Occurrences: --	Comments:	SPM: continuous until EOS
		  	ONC NURSING COMMUNICATION 20	Interval: --	Occurrences: --	Comments:	Concomitant medications: continuous from signing of ICF until 30d after last dose or until the start of SST, if earlier; thereafter, continue to report concomitant therapy given for any AEs/SAEs considered related to study treatment until EOS
		  	ONC NURSING COMMUNICATION 36	Interval: --	Occurrences: --	Comments:	SST
		  	ONC NURSING COMMUNICATION 37	Interval: --	Occurrences: --	Comments:	Survival: Every 16 weeks
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	Until 6 months after last dose
		  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --	Comments:	Arm A (Tal-P) only: Weekly for first 4 weeks from start of Pomalidomide administration. Thereafter Q28d (Q14d for those with irregular menses).
Serum or urine pregnancy test within 24 h prior to C1D1, at EOT and per local standards until 6 months after last dose.
			Labs
  	HIV-1 RNA, QUALITATIVE TMA	Interval: --	Occurrences: --	Comments:	To be done 3 and 6 months (±1 month) after last dose
		  	CD 4 SUBSET	Interval: --	Occurrences: --	Comments:	To be done 3 and 6 months (±1 month) after last dose
			Labs
  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Perform PCR testing Q12W (±4 weeks) up to 6 months after last dose of study treatment for participants with history of HBV infection/HCV antibody positivity.
		  	HEPATITIS C VIRUS (HCV), QUANTITATIVE PCR	Interval: --	Occurrences: --	Comments:	Perform PCR testing Q12W (±4 weeks) up to 6 months after last dose of study treatment for participants with history of HBV infection/HCV antibody positivity.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1. 
SPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Central laboratory. Local laboratory assessments may be used under specified circumstances. Sample may be collected on or within 7 d prior to CnD1.
UPEP assessments will continue until 30 d after the start of the first SST for participants with no PD or unconfirmed PD