title: Efficacy of lenalidomide plus dexamethasone for POEMS syndrome relapsed after autologous peripheral stem-cell transplantation.
abstract: POEMS syndrome is a rare paraneoplastic condition associated to an underlying plasmacellular dyscrasia. The pathogenesis of POEMS is poorly understood, but overproduction of VEGF, probably secreted by clonal plasma cells, is thought to be responsible for the signs and symptoms of the syndrome, and it seems to be useful for the monitoring of the response to therapy. At present, an effective therapeutic option for the patients is represented by autologous peripheral blood stem-cell transplantation (aPBSCT), although relapses have been described, and there is an important morbidity associated with this procedure. Before the implementation of aPBSCT, the clinical course of POEMS syndrome was characterized by progressive polyneuropathy potentially leading to death for respiratory failure. Given the high serum and plasma levels of VEGF observed in POEMS patients, the use of anti-angiogenetic drugs such as thalidomide and lenalidomide and other drugs with anti-VEGF and anti-TNF effect such as bortezomib have been considered to treat this syndrome. There are evidences of lenalidomide benefit in both front-line and previously treated patients, but scanty data are available about its use for relapse after aPBSCT. Here, we report the successful use of lenalidomide in a patient who relapsed after aPBSCT.
authors.affiliation: Department of Hematology, Catholic University of the Sacred Heart, Hospital A. Gemelli, Largo A. Gemelli 8, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Vannata
authors.forename: Luca
authors.initials: L
authors.lastname: Laurenti
authors.forename: Patrizia
authors.initials: P
authors.lastname: Chiusolo
authors.forename: Federica
authors.initials: F
authors.lastname: Sorà
authors.forename: Mario
authors.initials: M
authors.lastname: Balducci
authors.forename: Mario
authors.initials: M
authors.lastname: Sabatelli
authors.forename: Marco
authors.initials: M
authors.lastname: Luigetti
authors.forename: Claudia
authors.initials: C
authors.lastname: Giannotta
authors.forename: Valerio
authors.initials: V
authors.lastname: De Stefano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Leone
authors.forename: Simona
authors.initials: S
authors.lastname: Sica
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D006801:Humans; D006811:Humerus / Q000473:pathology / Q000528:radiation effects; D007155:Immunologic Factors / Q000008:administration & dosage; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D010026:Osteosclerosis / Q000209:etiology / Q000532:radiotherapy; D016878:POEMS Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D036102:Peripheral Blood Stem Cell Transplantation; D011239:Prednisolone / Q000008:administration & dosage; D012008:Recurrence; D016879:Salvage Therapy; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives; D014182:Transplantation, Autologous
chemical_list: D020533:Angiogenesis Inhibitors; D014408:Biomarkers, Tumor; D007155:Immunologic Factors; D013792:Thalidomide; D003907:Dexamethasone; D003520:Cyclophosphamide; D011239:Prednisolone; D000077269:Lenalidomide