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- W1572481826 abstract "OBJECTIVE: To study the neuropathy outcome following peripheral blood stem cell transplantation (PBSCT) in patients with POEMS syndrome.BACKGROUND: PBSCT is an effective treatment for POEMS but there are no large studies with long-term follow-up that assess the neurological improvement following PBSCT.DESIGN/METHODS: Retrospective chart review documenting the clinical, electrophysiological and laboratory characteristics of POEMS patients undergoing PBSCT at Mayo Clinic Rochester.RESULTS: Sixty patients were included. Median follow-up time was 61 months. All patients demonstrated neurological improvement following PBSCT apart from one patient who failed engraftment. Before PBSCT, 27 (45%) patients required a wheelchair and 17 (29%) required a walker or foot brace. At the end of the follow-up period, no patient was using a wheelchair. The median Neuropathy Impairment Score (NIS) improved from 66 to 48 points at 12 months and to 30 points at last follow-up (p<0.0001). Duration of symptoms prior to PBSCT correlated with higher baseline NIS. Median Rankin score improved from 3 to 1.5 (p<0.0001). Median VEGF improved from 452 to 64 pg/mL (p<0.0001) and median ulnar CMAP amplitude improved from 4.4 to 7.6 mV (p<0.0001). Predicted forced vital capacity improved from 83 to 93.5% (p<0.0001). There was no correlation between NIS improvement and change in VEGF level. Fourteen patients required additional chemotherapy and radiation following PBSCT, but there was no deterioration in the neuropathy in any of these patients. Six patients died; 1 due to failed engraftment, 5 due to other malignancies (3 MDS, 1 lymphoma,1 metastatic lung cancer). Periengraftment syndrome occurred in 40% of patients.CONCLUSIONS: POEMS patients who underwent PBSCT have significant improvement of their neuropathy during both short and long-term follow-up which corresponds to reduction in morbidity and disability. There is no correlation between neuropathy improvement and VEGF levels. Periengraftment syndrome was commonly seen but fatal complications were uncommon. Disclosure: Dr. Karam has received personal compensation in an editorial capacity for WriteClick Neurology. Dr. Dispenzieri has nothing to disclose. Dr. Mandrekar has nothing to disclose. Dr. Dyck has nothing to disclose. Dr. D9Souza has nothing to disclose. Dr. Mauermann has nothing to disclose." @default.
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- W1572481826 date "2014-04-08" @default.
- W1572481826 modified "2023-09-23" @default.
- W1572481826 title "Neuropathy Improvement Following Peripheral Blood Stem Cell Transplantation For POEMS Syndrome. (I6-2.002)" @default.
- W1572481826 hasPublicationYear "2014" @default.
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