title: [Clinical observation of thalidomide combined with VAD regimen for treatment of osteosclerotic myeloma (POEMS syndrome)].
abstract: This study was purposed to analyze the clinical features and evaluate the efficacy of thalidomide combined with VAD regimen for treatment of osteosclerotic myeloma (POEMS syndrome). The data of 27 patients with POEMS syndrome in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively, including clinical manifestations, laboratory tests, treatments and prognosis. The results showed that the polyneuropathy was observed in 27 patients (27/27), hepato-spleno-lymphadenectasis was found in 15 patients (15/27), endocrinopathy was found in 24 patients (24/27), skin changes was observed in 22 patients (22/27). M protein was found in 23 patients (23/27); in addition to these clinical manifestations, the papilledema serous cavity effusion and sclerotic bone lesion were also frequently observed in patients with POEMS syndrome. The remission rates of treatment of POEMS syndrome with thalidomide combined with VAD regimen for organomegaly, edema, skin changes, and endocrinopathy were 60, 58.3, 41 and 45.8 respectively. The level of serum M protein and the nervous system ODSS value decreased greatly after treatment (P < 0.01). It is concluded that the clinical characteristics of POEMS syndrome are complicated and easy to be misdiagnosed, and the evidence of monoclonal plasma cell hyperplasia should be actively searched for those patients whose serum M protein is negative. Thalidomide combined with VAD regimen for treatment of patients with POEMS syndrome has advantages such as significant curative effects, less side-effects, good tolerance, and higher safety and can be chosen as a preferred approach.
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Jian-Wen
authors.initials: JW
authors.lastname: Zhou
authors.forename: Hui
authors.initials: H
authors.lastname: Sun
authors.forename: Si-Lin
authors.initials: SL
authors.lastname: Gan
authors.forename: Yan-Fang
authors.initials: YF
authors.lastname: Liu
authors.forename: Ling
authors.initials: L
authors.lastname: Sun
authors.forename: Ding-Ming
authors.initials: DM
authors.lastname: Wan
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Meng
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D003561:Cytarabine; D003907:Dexamethasone; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000188:drug therapy*; D012189:Retrospective Studies; D013792:Thalidomide / Q000627:therapeutic use*; D014750:Vincristine
chemical_list: D003561:Cytarabine; D013792:Thalidomide; D014750:Vincristine; D003907:Dexamethasone