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POEMS综合征的最新进展。

Update on the POEMS syndrome.

作者信息

Kim Yu Ri

机构信息

Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea.

出版信息

Blood Res. 2022 Apr 30;57(S1):27-31. doi: 10.5045/br.2022.2022001.

Abstract

POEMS syndrome is an acronym for polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. It is a rare paraneoplastic disorder related to plasma cell neoplasm. However, its pathophysiology has not yet been clearly elucidated. The production of pro-inflammatory cytokines is thought to play an important role in the pathogenesis of POEMS syndrome. Vascular endothelial growth factor level reflects disease activity, which is helpful for the diagnosis and evaluation of treatment response. Conventional agents such as corticosteroids and melphalan are effective and safe combination regimens. Autologous hematopoietic stem cell transplantation is another option for high-risk transplant-eligible patients. Radiotherapy is effective in patients with localized lesions. The anti-myeloma agents lenalidomide, thalidomide, and bortezomib have shown good treatment outcomes for POEMS syndrome; however, large-scale studies with long-term follow-up are required. Early identification and active treatment can improve the outcomes of POEMS syndrome patients.

摘要

POEMS综合征是多发性神经病(polyneuropathy)、器官肿大(organomegaly)、内分泌病(endocrinopathy)、单克隆丙种球蛋白病(monoclonal gammopathy)和皮肤改变(skin changes)的首字母缩写。它是一种与浆细胞肿瘤相关的罕见副肿瘤性疾病。然而,其病理生理学尚未完全阐明。促炎细胞因子的产生被认为在POEMS综合征的发病机制中起重要作用。血管内皮生长因子水平反映疾病活动,有助于诊断和评估治疗反应。传统药物如皮质类固醇和马法兰是有效且安全的联合治疗方案。自体造血干细胞移植是适合进行高风险移植患者的另一种选择。放射治疗对局限性病变患者有效。抗骨髓瘤药物来那度胺、沙利度胺和硼替佐米对POEMS综合征显示出良好的治疗效果;然而,需要进行长期随访的大规模研究。早期识别和积极治疗可改善POEMS综合征患者的预后。

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