POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes) treated with autologous hematopoietic stem cell transplantation: a case report and literature review.
BACKGROUND
POEMS syndrome is a rare systemic pathology of paraneoplastic origin that is associated with plasma cell dyscrasia. It is characterized by the presence of sensorimotor polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes, and other systemic manifestations. The pathogenesis of the syndrome is unknown but over-production of vascular endothelial growth factor is probably responsible for most of the more characteristic symptoms. There is no standard treatment for POEMS syndrome and no randomized controlled clinical trials of treatment exist in the available literature. High-dose melphalan with autologous hematopoietic stem cell transplantation should be considered for younger patients with widespread osteosclerotic lesions, and for patients with rapidly progressive neuropathy.


METHODS
This is the case of a 62-year-old Caucasian man who was admitted to our center presenting pretibial edema accompanied by significant weight loss and difficulty walking. POEMS criteria were present and an immunofixation test confirmed the presence of a monoclonal plasmaproliferative disorder. After autologous hematopoietic stem cell transplantation, the monoclonal component disappeared and the patient's clinical status improved markedly.


CONCLUSIONS
Autologous hematopoietic stem cell transplantation following high-dose melphalan is an effective therapy for younger patients with widespread osteosclerotic lesions in POEMS syndrome.
Endocrinology and Nutrition Clinical Administration Unit, Virgen Macarena University Hospital, Sevilla, Spain.
Carlos
C
Arana
Internal Medicine Clinical Administration Unit, Virgen Macarena University Hospital, Sevilla, Spain.
José Antonio
JA
Pérez de León
Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
Gerardo
G
Gómez-Moreno
Internal Medicine Clinical Administration Unit, Virgen Macarena University Hospital, Sevilla, Spain.
Ramón
R
Pérez-Cano
Endocrinology and Nutrition Clinical Administration Unit, Virgen Macarena University Hospital, Sevilla, Spain.
Tomás
T
Martín Hernández
D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000175:diagnosis* / Q000628:therapy*; D014182:Transplantation, Autologous