Effective treatment of POEMS syndrome accompanied by plasmacytoma with lenalidomide, dexamethasone, and local irradiation

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  • TAKAHASHI Wataru
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • ICHIKAWA Motoshi
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • OKAZAKI Akihito
    Clinical Training Center, Dokkyo Medical University Hospital
  • NAKAMURA Fumi
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • ARAI Honoka
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • HANDA Tomoyuki
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • NAKAMURA Yuko
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • NAKAMURA Yuka
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • SEO Sachiko
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • SASAKI Ko
    Department of Hematology and Oncology, Dokkyo Medical University Hospital
  • MITANI Kinuko
    Department of Hematology and Oncology, Dokkyo Medical University Hospital

Bibliographic Information

Other Title
  • 形質細胞腫を併発しlenalidomide＋dexamethasone療法および局所放射線照射が有効であったPOEMS症候群
  • 症例報告 第10回日本血液学会関東甲信越地方会 奨励賞 形質細胞腫を併発しlenalidomide+dexamethasone療法および局所放射線照射が有効であったPOEMS症候群
  • ショウレイ ホウコク ダイ10カイ ニホン ケツエキ ガッカイ カントウ コウシンエツチホウカイ ショウレイショウ ケイシツ サイボウ シュ オ ヘイハツ シ lenalidomide+dexamethasone リョウホウ オヨビ キョクショ ホウシャセン ショウシャ ガ ユウコウ デ アッタ POEMS ショウコウグン

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Abstract

<p>A 70-year-old woman experienced pain in both gastrocnemius muscles, numbness in the toes, and muscle weakness in both the legs that lasted for two months. After getting admitted to our hospital, the muscle weakness extended to both her arms, and nerve conduction studies revealed decreased nerve conduction velocity, which was more prominent in the elbow and the axilla than in the wrist. A magnetic resonance imaging revealed a tumor in the right femoral neck, which was histologically diagnosed as plasmacytoma. Laboratory findings revealed IgA lambda type M protein and an elevated VEGF level of 2,320 pg/ml; edema was present in both the legs. After a diagnosis of POEMS syndrome, lenalidomide and dexamethasone treatment were initiated simultaneously, along with irradiation. The treatment improved polyneuropathy, along with a decrease in the VEGF level. Increased vascular permeability due to elevated VEGF led to the development of neuropathy of POEMS syndrome, and treatment against proliferating monoclonal plasma cells is effective. In the present case, we believe that a prompt control of the plasmacytoma with novel therapeutic agents for myeloma with irradiation resulted in the improvement of the neurological symptoms.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 61 (3), 262-267, 2020

    The Japanese Society of Hematology

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