POEMS Syndrome: Therapeutic Options

Hematol Oncol Clin North Am. 2018 Feb;32(1):141-151. doi: 10.1016/j.hoc.2017.09.011.

Abstract

Treatment of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome should be directed at the underlying plasma cell clone with risk-adapted therapy based on the extent of the plasma cell disorder. Radiation therapy is effective for patients with a localized presentation, without bone marrow involvement, and 1 to 3 bone lesions. Patients with disseminated disease should receive, preferably, high-dose chemotherapy with peripheral blood transplantation. Low-dose melphalan and dexamethasone or new agents used in myeloma are also effective. The most promising agent is lenalidomide, which could be given before high-dose therapy or radiation to get rapid neurologic responses.

Keywords: Autologous stem cell transplantation; Bortezomib; Lenalidomide; POEMS syndrome; Thalidomide; VEGF.

Publication types

  • Review

MeSH terms

  • Allografts
  • Humans
  • Lenalidomide
  • POEMS Syndrome / diagnosis
  • POEMS Syndrome / pathology
  • POEMS Syndrome / therapy*
  • Peripheral Blood Stem Cell Transplantation*
  • Radiotherapy
  • Thalidomide / analogs & derivatives*
  • Thalidomide / therapeutic use

Substances

  • Thalidomide
  • Lenalidomide