title: Autologous cytokine-induced killer (CIK) cell immunotherapy combined with cyclophosphamide in five patients with POEMS syndrome.
abstract: The primary objective of this study was to evaluate the safety and clinical efficacy of autologous cytokine-induced killer (CIK) cells combined with cyclophosphamide in the treatment of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome patients. We evaluated five POEMS syndrome patients treated with autologous CIK cell immunotherapy combined with cyclophosphamide from 1 May 2012 to 30 November 2014. The Overall Neuropathy Limitation Scale (ONLS), computed tomography of the chest and abdomen, ultrasound of the abdomen, serum vascular endothelial growth factor (VEGF) level and lymphocyte count findings in the five patients were recorded. The median age of the patients was 40 years (range: 25-62), and all the patients were male. CIK cells were generated routinely from peripheral blood mononuclear cells (PBMCs) of all five patients, and the numbers of CIK cells increased by approximately 105-fold after 14 days of culture. All five patients (100%) responded to their neuropathy treatment, the ONLS scores were reduced by at least 1 and a paired-sample t-test revealed a significant difference (t = 5·715, P = 0·003 < 0·01). The extravascular volume overload responses indicated partial remission (PR = 60%) or stable disease (SD = 40%), and no cases of progressive disease (PD) or complete remission (CR) were observed. During clinical treatment, the serum VEGF of patient 5 decreased after one cycle of transfusion within 1 month. The lymphocyte counts of all the patients increased significantly after CIK transfusion, and a paired-sample t-test revealed a significant difference (t = 5·101, P = 0·004 < 0·01). Autologous CIK cell infusion combined with cyclophosphamide was found to be highly safe and elicited no adverse reactions. CIK cells can improve both the symptoms and quality of life, decrease serum VEGF levels and increase lymphocyte counts in patients with POEMS syndrome.
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Immunology, Institute of Basic Medicine, School of Life Sciences, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Haematology, Chinese PLA General Hospital, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Bo
authors.affiliation: Department of Immunology, Institute of Basic Medicine, School of Life Sciences, Beijing, China.
authors.forename: W
authors.initials: W
authors.lastname: Han
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, China.
authors.forename: S
authors.initials: S
authors.lastname: Yu
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, China.
authors.forename: R
authors.initials: R
authors.lastname: Liu
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D049109:Cell Proliferation; D002478:Cells, Cultured; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D055612:Cytokine-Induced Killer Cells / Q000166:cytology / Q000276:immunology / Q000637:transplantation*; D005260:Female; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011788:Quality of Life; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013909:Thorax / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014463:Ultrasonography; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D018906:Antineoplastic Agents, Alkylating; D042461:Vascular Endothelial Growth Factor A; D003520:Cyclophosphamide
keywords: POEMS syndrome; clinical efficacy and safety; cyclophosphamide; cytokine-induced killer (CIK) cell; lymphocyte; vascular endothelial growth factor (VEGF)