POEMS syndrome: 2021 Update on diagnosis, risk-stratification, and management.
Angela DispenzieriPublished in: American journal of hematology (2021)
For those patients with a dominant plasmacytoma, first line therapy is irradiation. Patients with diffuse sclerotic lesions or disseminated bone marrow involvement and for those who have progression of their disease 3-6 months after completing radiation therapy should receive systemic therapy. Corticosteroids are temporizing, but alkylators are the mainstay of treatment, either in the form of low dose conventional therapy or high dose with stem cell transplantation. Lenalidomide shows promise with manageable toxicity. Thalidomide and bortezomib also have activity, but their benefit needs to be weighed against their risk of exacerbating the peripheral neuropathy. 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
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- healthcare
- mesenchymal stem cells
- type diabetes
- palliative care
- stem cells
- cell therapy
- metabolic syndrome
- oxidative stress
- chronic pain
- radiation induced
- weight loss
- quality improvement
- newly diagnosed
- big data
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- deep learning
- replacement therapy