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Factors associated with the efficiency of PBSC collection in POEMS syndrome patients undergoing autologous PBSC transplantation

Bone Marrow Transplantation volume 47, pages 1010–1012 (2012)Cite this article

Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin abnormalities (POEMS) syndrome is a rare plasma cell dyscrasia defined by the presence of peripheral neuropathy, monoclonal plasma cells and paraneoplastic features, such as skin changes and generalized edema.1 Although the pathogenesis of this syndrome is unclear, it is believed to be related to excessive production of vascular endothelial growth factor (VEGF), probably secreted by clonal plasma cells or abnormally released by activated platelets.2 Increased VEGF production appears to cause most disease features such as polyneuropathy, by inducing angiogenesis and microvascular hyperpermeability.

In the past decade, treatment of POEMS syndrome has expanded to include high-dose (HD) melphalan, followed by autologous PBSC transplantation (ASCT) and novel agents, including thalidomide, lenalidomide and bortezomib. Numerous reports have demonstrated that ASCT is the most effective therapy for these patients, causing improvement in multiple symptoms and VEGF levels.3, 4, 5, 6, 7 However, collection of PBSCs in patients with POEMS syndrome is challenging, and such patients are at a higher risk than those with lymphoma or myeloma because of poor performance status (PS), morbidities associated with uncontrollable effusions or splenomegaly, and high serum VEGF levels. As the appropriate timing and factors associated with the efficiency of PBSC collection are unclear, we analyzed the factors affecting the efficiency of cell collection and engraftment in POEMS syndrome patients.

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Acknowledgements

We extend heartfelt thanks to Ms Mami Shimizu and Mr Shigeru Yoshizawa for their assistance with the statistical analyses.

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Authors and Affiliations

  1. Department of Hematology, Chiba University Hospital, Chiba City, Japan

    N Shimizu, C Nakaseko, E Sakaida, C Ohwada, M Takeuchi, T Kawaguchi, S Tsukamoto, S Sakai, Y Takeda & D Abe

  2. Department of Blood Transfusion, Chiba University Hospital, Chiba City, Japan

    N Shimizu & T Iseki

  3. Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba City, Japan

    K Yokote

  4. Department of Neurology, Chiba University Graduate School of Medicine, Chiba City, Japan

    K Kanai, S Misawa & S Kuwabara

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  1. N Shimizu
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Correspondence to C Nakaseko.

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Shimizu, N., Nakaseko, C., Sakaida, E. et al. Factors associated with the efficiency of PBSC collection in POEMS syndrome patients undergoing autologous PBSC transplantation. Bone Marrow Transplant 47, 1010–1012 (2012). https://doi.org/10.1038/bmt.2011.211

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