POEMS syndrome is characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes. Bortezomib is an important component of the chemotherapy regimen associated with multiple myeloma, and has been previously applied to POEMS syndrome. We present a 56-year-old Chinese man who was given subcutaneous administration of bortezomib as part of the BDex (bortezomib–dexamethasone) regimen for his POEMS syndrome. The peripheral neuropathy and laboratory-test results of the patient improved dramatically with 4 cycles of treatment, resulting in a complete response. In addition, the treatment was well tolerated and adequate peripheral blood hematopoietic stem cells were collected for an ensuing autologous stem cell transplant.

Keywords:
POEMS syndrome, Bortezomib, Subcutaneous administration, Induction therapy
1.
Argyriou AA, Iconomou G, Kalofonos HP: Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature. Blood 2008;112:1593–1599.
2.
Kaygusuz I, Tezcan H, Cetiner M, Kocakaya O, Uzay A, Bayik M: Bortezomib: a new therapeutic option for POEMS syndrome. Eur J Haematol 2010;84:175–177.
3.
Ohguchi H, Ohba R, Onishi Y, Fukuhara N, Okitsu Y, Yamamoto J, Ishizawa K, Ichinohasama R, Harigae H: Successful treatment with bortezomib and thalidomide for POEMS syndrome. Ann Hematol 2011;90:1113–1114.
4.
Tang X, Shi X, Sun A, Qiu H, Gu B, Zhou H, Xue S, Liu Y, Ruan C, Wu D: Successful bortezomib-based treatment in POEMS syndrome. Eur J Haematol 2009;83:609–610.
5.
Wang X, Ye S, Xiong C, Gao J, Xiao C, Xing X: Successful treatment with bortezomib and thalidomide for POEMS syndrome associated with multicentric mixed-type Castleman’s disease. Jpn J Clin Oncol 2011;41:1221–1224.
6.
Moreau P, Pylypenko H, Grosicki S, Karamanesht I, Leleu X, Grishunina M, Rekhtman G, Masliak Z, Robak T, Shubina A, Arnulf B, Kropff M, Cavet J, Esseltine DL, Feng H, Girgis S, van de Velde H, Deraedt W, Harousseau JL: Subcutaneous versus intravenous administration of bortezomib in patients with relapsed multiple myeloma: a randomised, phase 3, non-inferiority study. Lancet Oncol 2011;12:431–440.
7.
Dispenzieri A: POEMS syndrome: 2011 update on diagnosis, risk-stratification, and management. Am J Hematol 2011;86:591–601.
8.
Li J, Zhang W, Jiao L, Duan MH, Guan HZ, Zhu WG, Tian Z, Zhou DB: Combination of melphalan and dexamethasone for patients with newly diagnosed POEMS syndrome. Blood 2011;117:6445–6449.
9.
Creange A, Chater A, Brouet JC, Jaccard A, Rahmouni A, Lefaucheur JP, Santin A: A case of POEMS syndrome treated by autologous hematopoietic stem-cell transplantation. Nat Clin Pract Neurol 2008;4:686–691.
10.
Warsame R, Kohut IE, Dispenzieri A: Successful use of cyclophosphamide, bortezomib, and dexamethasone to treat a case of relapsed POEMS. Eur J Haematol 2012;88:549–550.
11.
Sobas MA, Alonso Vence N, Diaz Arias J, Bendana Lopez A, Fraga Rodriguez M, Bello Lopez JL: Efficacy of bortezomib in refractory form of multicentric Castleman disease associated to POEMS syndrome (MCD- POEMS variant). Ann Hematol 2010;89:217–219.
12.
Richardson PG, Delforge M, Beksac M, Wen P, Jongen JL, Sezer O, Terpos E, Munshi N, Palumbo A, Rajkumar SV, Harousseau JL, Moreau P, Avet-Loiseau H, Lee JH, Cavo M, Merlini G, Voorhees P, Chng WJ, Mazumder A, Usmani S, Einsele H, Comenzo R, Orlowski R, Vesole D, Lahuerta JJ, Niesvizky R, Siegel D, Mateos MV, Dimopoulos M, Lonial S, Jagannath S, Blade J, Miguel JS, Morgan G, Anderson KC, Durie BG, Sonneveld P: Management of treatment-emergent peripheral neuropathy in multiple myeloma. Leukemia 2012;26:595–608.
13.
Sonneveld P, Jongen JL: Dealing with neuropathy in plasma-cell dyscrasias. Hematology Am Soc Hematol Educ Program 2010;2010:423–430.
14.
Richardson PG, Xie W, Mitsiades C, Chanan-Khan AA, Lonial S, Hassoun H, Avigan DE, Oaklander AL, Kuter DJ, Wen PY, Kesari S, Briemberg HR, Schlossman RL, Munshi NC, Heffner LT, Doss D, Esseltine DL, Weller E, Anderson KC, Amato AA: Single-agent bortezomib in previously untreated multiple myeloma: efficacy, characterization of peripheral neuropathy, and molecular correlations with response and neuropathy. J Clin Oncol 2009;27:3518–3525.
15.
Bringhen S, Larocca A, Rossi D, Cavalli M, Genuardi M, Ria R, Gentili S, Patriarca F, Nozzoli C, Levi A, Guglielmelli T, Benevolo G, Callea V, Rizzo V, Cangialosi C, Musto P, De Rosa L, Liberati AM, Grasso M, Falcone AP, Evangelista A, Cavo M, Gaidano G, Boccadoro M, Palumbo A: Efficacy and safety of once-weekly bortezomib in multiple myeloma patients. Blood 2010;116:4745–4753.
16.
Moreau P, Coiteux V, Hulin C, Leleu X, van de Velde H, Acharya M, Harousseau JL: Prospective comparison of subcutaneous versus intravenous administration of bortezomib in patients with multiple myeloma. Haematologica 2008;93:1908–1911.
17.
Dispenzieri A, Kyle RA: Neurological aspects of multiple myeloma and related disorders. Best Pract Res Clin Haematol 2005;18:673–688.
18.
Richardson PG, Sonneveld P, Schuster MW, Stadtmauer EA, Facon T, Harousseau JL, Ben-Yehuda D, Lonial S, Goldschmidt H, Reece D, Blade J, Boccadoro M, Cavenagh JD, Boral AL, Esseltine DL, Wen PY, Amato AA, Anderson KC, San Miguel J: Reversibility of symptomatic peripheral neuropathy with bortezomib in the phase III apex trial in relapsed multiple myeloma: impact of a dose-modification guideline. Br J Haematol 2009;144:895–903.
19.
Kuwabara S: New treatment strategy for Crow-Fukase (POEMS) syndrome. Rinsho Shinkeigaku 2010;50:794–796.
20.
Roccaro AM, Hideshima T, Raje N, Kumar S, Ishitsuka K, Yasui H, Shiraishi N, Ribatti D, Nico B, Vacca A, Dammacco F, Richardson PG, Anderson KC: Bortezomib mediates antiangiogenesis in multiple myeloma via direct and indirect effects on endothelial cells. Cancer Res 2006;66:184–191.
21.
Ohwada C, Nakaseko C, Sakai S, Takeda Y, Abe D, Takeuchi M, Sakaida E, Masuda S, Shimizu N, Cho R, Nishimura M, Kanai K, Misawa S, Kuwabara S: Successful combination treatment with bevacizumab, thalidomide and autologous PBSC for severe POEMS syndrome. Bone Marrow Transplant 2009;43:739–740.
© 2012 S. Karger AG, Basel
2012
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