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Histocompatibility and Donor Selection

PBSC mobilization in newly diagnosed patients with POEMS syndrome: outcomes and prognostic factors

Bone Marrow Transplantation volume 48, pages 233–237 (2013)Cite this article

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Abstract

Autologous PBSC transplantation is a preferred treatment for patients with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS syndrome). However, data on stem cell mobilization in POEMS syndrome are limited. We retrospectively reviewed outcomes and factors prognostic of mobilization in newly diagnosed patients with POEMS syndrome. A total of 56 patients (41 men and 15 women) were included and the median age was 45 years (range, 24–62). All patients underwent mobilization with CY plus granulocyte CSF (G-CSF) (n=38) or G-CSF alone (n=18). The median total number of harvested CD34+ cells was 2.01 × 106/kg (range, 0.18–9.0 × 106/kg). In all, 29 (51.8%) patients failed to yield more than 2 × 106/kg CD34+ cells, and among them, 7 (12.5%) patients yielded <1 × 106/kg CD34+ cells. The overall mobilization-related morbidity was 23.3% and acute renal failure was the most common complication during mobilization. Multivariate analysis showed that hepatomegaly (odds ratio 0.06, 95% confidence interval (CI) 0.01–0.43) and mobilization regimen of G-CSF alone (odds ratio 0.08, 95% CI 0.01–0.70) were independent prognostic factors for successful mobilization in POEMS syndrome. In conclusion, mobilization in newly diagnosed patients with POEMS syndrome is challenging with low yield of CD34+ cells and high morbidity. Induction therapy before mobilization might improve the efficacy and safety of mobilization.

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Acknowledgements

This work was supported by a grant from Capital Research Fund on Clinical Application (Z111107058811019)

Author contributions: JL, WZ and DBZ designed the study, analyzed the data and wrote the paper. MHD, LJ, TNZ and BH contributed to the collection of data. LZ and JG contributed to mobilization and harvest of stem cell.

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  1. J Li and W Zhang: These authors contributed equally to this study.

Authors and Affiliations

  1. Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China

    J Li, W Zhang, M-H Duan, L Jiao, T-N Zhu, B Han, L Zhang & D-B Zhou

  2. Department of Blood Transfusion, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    J Gan

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  1. J Li
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Correspondence to D-B Zhou.

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Li, J., Zhang, W., Duan, MH. et al. PBSC mobilization in newly diagnosed patients with POEMS syndrome: outcomes and prognostic factors. Bone Marrow Transplant 48, 233–237 (2013). https://doi.org/10.1038/bmt.2012.138

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