Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

21 May 2009

Autologous haematopoietic stem cell transplantation followed by thalidomide therapy in poems syndrome

M Cioch, J Manko

Ann Transplant 2009; 14(1): 74-75 :: ID: 880474

Abstract

Background: POEMS syndrome is a rare plasmatic cell dyscrasia, which is associated with overproduction of VEGF and characterized by polyneuropathy,
organomegaly, endocrinopathy, monoclonal gammapathy, and skin changes. A specific treatment for this disease is not established. In recent reports, high dose chemotherapy followed by autologous haematopoietic stem cell transplantation (AHSCT), performed at an early stage can improve clinical
symptoms, especially for polyneuropathy. We describe the clinical course of a patient with POEMS syndrome in an advanced stage and unresponsive to chemotherapy.
Case Report: A 47-year-old man was admitted to Department of
Haematooncology and Bone Marrow Transplantation of Medical University in Lublin with quadriparesis, hepatosplenomegaly, sclerotic bone lesion, acrocyanosis, IgG lambda gammapathy and thrombocytosis. The result of a myelogram was normal. The first symptoms of the disease appeared three
years ago and diagnosis of POEMS was established 18 months ago. The patient was unresponsive to chemotherapy that consisted of cyclophosphamide and prednisone, so we decided to perform AHSCT. Peripheral blood stem cells were collected after mobilization by
cyclophosphamide (4g/m2) and G-CSF. The number of collected CD34+ cells was 12-106/kg. The conditioning regimen was with high dose melphalan (140 mg/m2). The number of transplanted CD34+ cells was 4-106/kg. The post-transplantation course was complicated by fever with no identifi able infectious aetiology, diarrhoea, cutaneous rash and swelling without hipoalbuminaemia (engraftment syndrome?). Neutrophil (0.5 G/l) and platelet (20 G/l) engraftment occurred on days 11 and 13, respectively. The improvement was manifested by disappearance of gammapathy and organomegaly. The withdrawal of neurological symptoms was unsatisfactory. Further improvement of neurological status was achieved after thalidomide therapy. The second autologous transplantation is considered.

Keywords: Stem Cell Transplantation, case report

Add Comment 0 Comments

In Press

12 Feb 2024 : Original article  

No Prognostic Impact of Graft-to-Recipient Weight Ratio on Hepatocellular Carcinoma Recurrence Following Li...

Ann Transplant In Press; DOI: 10.12659/AOT.942767  

21 Feb 2024 : Original article  

Use of LCP-Tacrolimus (LCPT) in Kidney Transplantation: A Delphi Consensus Survey of Expert Clinicians

Ann Transplant In Press; DOI: 10.12659/AOT.943498  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358