title: [Rapid improvement of fluid retention with lenalidomide plus low-dose dexamethasone for POEMS syndrome relapsed after autologous peripheral blood stem cell transplantation].
abstract: We report a 53-year-old male with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome who relapsed after autologous peripheral stem cell transplantation (ASCT), but responded extremely well to lenalidomide (LEN) plus low dose dexamethasone (Ld) therapy. The patient had been diagnosed with POEMS syndrome in November 2006, and underwent ASCT in February 2007. In July 2011, he developed respiratory distress, generalized edema, and massive bilateral pleural effusion. Plasma vascular endothelial growth factor (VEGF) and M protein were increased, strongly indicating a relapse. Ld therapy was remarkably effective for these symptoms, resulting in complete remission with M-protein becoming undetectable by immunofixation. Since completing 11 courses of therapy with an every 4 weeks regimen, he has remained in clinical remission. The patient's activities of daily living have also markedly improved from total physical incapacity to being able to stand with slight assistance. LEN is associated with a lower incidence of peripheral neuropathy than other new drugs. Although LEN has occasionally been given to patients with POEMS syndrome in recent years, there are still few reports on its use for patients with recurrent disease after ASCT. Our successful management of this patient suggests that Ld therapy is not only relatively safe but also a promising option for POEMS syndrome relapsing after ASCT.
authors.affiliation: Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center.
authors.forename: Kota
authors.initials: K
authors.lastname: Ohashi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yokoyama
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kagoo
authors.forename: Toru
authors.initials: T
authors.lastname: Hosoda
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Mie
authors.initials: M
authors.lastname: Yoneda
authors.forename: Masahisa
authors.initials: M
authors.lastname: Kudo
authors.forename: Saigen
authors.initials: S
authors.lastname: Boku
authors.forename: Hironori
authors.initials: H
authors.lastname: Ueno
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yano
mesh_terms: D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000175:diagnosis / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D055502:Secondary Prevention; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide