POEMS syndrome: Update on diagnosis, risk-stratification, and management.
Angela DispenzieriPublished in: American journal of hematology (2023)
For those patients with a dominant plasmacytoma, first-line therapy is irradiation. Patients with diffuse sclerotic lesions or disseminated bone marrow involvement should receive systemic therapy. Corticosteroids are temporizing, but alkylators and lenalidomide are the mainstays of treatment, the former either in the form of low-dose conventional therapy or as high-dose conditioning for stem cell transplantation. Thalidomide and bortezomib also have activity, but their benefit needs to be weighed against their risk of exacerbating the peripheral neuropathy. Daratumumab combinations also appear promising based on case series. Prompt recognition and institution of both supportive care measures and therapy directed against the plasma cell result in the best outcomes.
Keyphrases
- high dose
- stem cell transplantation
- low dose
- bone marrow
- multiple myeloma
- healthcare
- mesenchymal stem cells
- stem cells
- type diabetes
- single cell
- palliative care
- metabolic syndrome
- case report
- quality improvement
- newly diagnosed
- low grade
- weight loss
- insulin resistance
- replacement therapy
- radiation induced
- affordable care act
- chronic lymphocytic leukemia