RT Journal Article
SR Electronic
T1 Thalidomide reduces serum VEGF levels and improves peripheral neuropathy in POEMS syndrome
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 1255
OP 1257
DO 10.1136/jnnp.2008.150177
VO 79
IS 11
A1 S Kuwabara
A1 S Misawa
A1 K Kanai
A1 S Sawai
A1 T Hattori
A1 M Nishimura
A1 C Nakaseko
YR 2008
UL http://jnnp.bmj.com/content/79/11/1255.abstract
AB 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.