Thalidomide reduces serum VEGF levels and improves peripheral neuropathy in POEMS syndrome
- 1Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
- 2Division of Haematology, Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Satoshi Kuwabara, Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260–8670, Japan; kuwabara-s{at}faculty.chiba-u.jp
- Received 22 March 2008
- Revised 28 April 2008
- Accepted 28 April 2008
- Published Online First 9 May 2008
Abstract
Background: Polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes (POEMS) syndrome is a rare multi-system disorder associated with plasma-cell dyscrasia. Several case series and reports have suggested that high-dose chemotherapy with autologous peripheral blood stem-cell transplantation is efficacious treatment, but this transplantation is not indicated for elderly patients and patients with renal failure.
Objective: To investigate the effects of thalidomide treatment for POEMS syndrome.
Methods: Nine patients, who were not indicated for high-dose chemotherapy, were treated with thalidomide. Neurological disability scores, nerve conduction studies and serum levels of vascular endothelial growth factor (VEGF) were prospectively examined. VEGF levels were measured by an enzyme-linked immunosorbent assay.
Results: During follow-up periods of 8–23 months (mean, 15 months), all patients showed substantial clinical improvement (n = 6) or stabilisation of symptoms (n = 3). Serum VEGF levels decreased in all patients and were normalised in five patients. Nerve conduction velocities in the median nerve increased in seven patients. There were no serious adverse effects, including thalidomide neuropathy.
Conclusion: Thalidomide treatment should be further studied as a treatment for POEMS syndrome, particularly for patients who are not indicated for transplantation therapy.
Footnotes
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Competing interests: None.
