Efficacy and safety of low-dose lenalidomide plus dexamethasone in patients with relapsed or refractory POEMS syndrome.

Abstract

Although autologous stem cell transplantation or melphalan-based chemotherapy has significantly improved the prognosis of POEMS syndrome, a few patients will relapse or be refractory to primary therapy, and there is a lack of studies regarding these patients. In this study, we used low-dose lenalidomide (10 mg daily) and dexamethasone (40 mg, once weekly) to treat twelve patients with relapsed (n = 8) or refractory (n = 4) POEMS syndrome. After a median follow-up time of 20 months, the overall hematologic response rate was 77% with 44% having a complete response. Eight (67%) patients had neurological response, and the median overall neuropathy limitation scale score was reduced from 3 (range, 1-9) to 2 (range, 0-6). Serum vascular endothelial growth factor response rate was 91% and 46% of patients had normal serum VEGF levels. One patient had progression of the disease 3 months after the end of treatment and subsequently died from the disease. Therefore, the estimated 2 year overall survival and progression-free survival were 92%. The low-dose lenalidomide and dexamethasone regimen was well tolerated, with no treatment-related death or any grade 3 or 4 toxicity. In conclusion, low-dose lenalidomide plus dexamethasone therapy is an effective and safe regimen for patients with relapsed or refractory POEMS syndrome.

• Authors: Qian-Qian Cai, Chen Wang, Xin-Xin Cao, Hao Cai, Dao-Bin Zhou, Jian Li
• Journal: European journal of haematology (Eur J Haematol) Vol. 95 Issue 4 Pg. 325-30 (Oct 2015) ISSN: 1600-0609 [Electronic] England
• PMID: 25401269 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Thalidomide
• Dexamethasone
• Lenalidomide

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Combined Modality Therapy
• Dexamethasone (administration & dosage)
• Female
• Follow-Up Studies
• Humans
• Lenalidomide
• Male
• Middle Aged
• POEMS Syndrome (drug therapy, mortality, therapy)
• Recurrence
• Thalidomide (administration & dosage, analogs & derivatives)
• Treatment Outcome