title: Relapse of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome without increased level of vascular endothelial growth factor following successful autologous peripheral blood stem cell transplantation.
abstract: We report a patient with polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome who experienced relapse after successful treatment with autologous peripheral blood stem cell transplantation (auto-PBSCT). Interestingly, although vascular endothelial growth factor (VEGF) levels were positively correlated with disease activity before and after auto-PBSCT, as expected, levels did not increase at the time of relapse. The patient was treated with doxorubicin, dexamethasone, and diuretics, followed by thalidomide, and remains clinically stable at one year after treatment. This case suggests that VEGF level may not always be indicative of relapse of POEMS syndrome, and that thalidomide is both useful and safe for patients with relapse following successful treatment with auto-PBSCT.
authors.affiliation: Department of Neurology, Shizuoka Red Cross Hospital, Shizuoka, Japan. nboimai@ac.mbn.or.jp
authors.forename: Noboru
authors.initials: N
authors.lastname: Imai
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Yagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Konishi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Serizawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kobari
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001804:Blood Transfusion, Autologous / Q000379:methods*; D003907:Dexamethasone / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D016878:POEMS Syndrome / Q000097:blood / Q000503:physiopathology* / Q000628:therapy*; D012008:Recurrence; D013234:Stem Cells / Q000502:physiology; D013792:Thalidomide / Q000627:therapeutic use; D017211:Treatment Failure; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis / Q000097:blood
chemical_list: D000903:Antibiotics, Antineoplastic; D015415:Biomarkers; D004232:Diuretics; D007166:Immunosuppressive Agents; D042461:Vascular Endothelial Growth Factor A; D013792:Thalidomide; D003907:Dexamethasone; D004317:Doxorubicin