Published in:
01-09-2012 | Original Article
POEMS syndrome treated with melphalan high-dose therapy and autologous blood stem cell transplantation: a single-institution experience
Authors:
Gabriela B. Thoennissen, Nils H. Thoennissen, Fleur Fritz, Andreas Hilbig, Andrea Kerkhoff, Ruediger Liersch, Utz Krug, Steffen Koschmieder, Carsten Müller-Tidow, Rolf Mesters, Martin Kropff, Wolfgang E. Berdel
Published in:
Annals of Hematology
|
Issue 9/2012
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Abstract
The acronym POEMS syndrome stands for a rare multi-system disorder, comprised of polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. Here, we present a single-center report of a series of five POEMS patients treated with melphalan high-dose therapy (HDT) with subsequent autologous blood stem cell transplantation (ABSCT). After a median follow-up of 52 months from time of diagnosis (range, 15–192) and a median follow-up of 18 months after ABSCT (range, 11–120), all patients were alive. Overall, no severe transplantation-associated complications such as engraftment syndrome or peri- or post-transplant death were noted. In two cases, HDT followed by ABSCT resulted in a complete hematologic response; in the additional three cases, partial responses (PR) were achieved including one very good hematologic PR. Only one patient with initial PR developed progressive disease nearly 2.5 years after transplantation. Consequently, a second HDT with ABSCT was successfully applied resulting in clinical improvement and hematologic PR. In line with previous single-center reports, melphalan HDT followed by ABSCT proved to be a first-line treatment option with tolerable side effects in severely affected POEMS patients with progressing symptoms.