Dramatic improvement of POEMS syndrome by stem cell transplantation parallels decrease in VEGF and BFGF level

C. Schrader, M. Tiemann, U. Zirrgiebel, A. Günther, D. Janssen, M. Gramatzki
2006 Biology of Blood and Marrow Transplantation  
geneic transplant due to older age, comorbidities or lack of HLAidentical donor. Median age at transplant was 52 years (range 37-68), median interval between first and second autograft was 26 months (range 3-73). Eleven patients had persistent or progressive disease at transplant. Twenty patients received high-dose melphalan alone or in combination, while 2 received a combination of thiotepa, busulfan and cyclophosphamide. Patients had received an average of 6 prior chemotherapy regimens.
more » ... netic studies were available in 18/22 patients at the time of transplant, 12 were normal and 6 abnormal. Results: 14 of the 21 evaluable patients (70%) achieved a response (1 CR, 13 PR). After a median follow-up of 15 months (2-82), 1 year progression-free survival (PFS) was 40% and 1-year overall survival (OS) was 78%. 100-day TRM was 0%. Median PFS was 10 months, and median OS has not been reached. On univariate analysis, abnormal cytogenetics at transplant was a predictor of shorter overall survival (P ϭ .01). Conclusions: In patients with progressive disease after an autologous transplant, salvage autologous transplants may achieve responses in 70% of patients with durable remissions in a small subset. Normal cytogenetics at second transplant predicts a longer survival.
doi:10.1016/j.bbmt.2005.11.375 fatcat:kopjpn3dtrc6xktjk4efj3dn74