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达雷妥尤单抗联合来那度胺和地塞米松治疗伴有17p缺失的骨浆细胞瘤复发的POEMS综合征

Daratumumab plus lenalidomide and dexamethasone for relapsed POEMS syndrome with bone plasmacytoma harboring 17p deletion.

作者信息

Oyama Takashi, Taoka Kazuki, Chiba Akira, Masamoto Yosuke, Ikemura Masako, Honda Akira, Maki Hiroaki, Kurokawa Mineo

机构信息

Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.

Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.

出版信息

Int J Hematol. 2023 Mar;117(3):463-467. doi: 10.1007/s12185-022-03459-w. Epub 2022 Oct 6.

Abstract

The standard therapies for polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome are radiation therapy, high-dose chemotherapy followed by autologous stem cell transplantation, and lenalidomide combined with dexamethasone. Daratumumab was reported to be effective for treatment-naive and relapsed POEMS syndrome, but treatment options for relapsed POEMS syndrome with poor prognostic factors or cytogenetic abnormalities have not been established due to a lack of studies in these patients. Here, we describe a case of relapsed POEMS syndrome with bone plasmacytoma harboring a newly detected 17p deletion after high-dose chemotherapy followed by autologous stem cell transplantation and radiation therapy in a male patient. He was successfully treated with daratumumab plus lenalidomide and dexamethasone (Dara-Rd). Dara-Rd could be effective in relapsed POEMS syndrome with 17p deletion, which is known as a poor cytogenetic abnormality in multiple myeloma. This report may broaden the application of Dara-Rd for POEMS syndrome.

摘要

多神经病、器官肿大、内分泌病、单克隆蛋白血症和皮肤改变(POEMS)综合征的标准治疗方法是放射治疗、大剂量化疗后进行自体干细胞移植,以及来那度胺联合地塞米松。据报道,达雷妥尤单抗对初治和复发的POEMS综合征有效,但由于缺乏针对这些患者的研究,对于具有不良预后因素或细胞遗传学异常的复发POEMS综合征的治疗方案尚未确立。在此,我们描述了一例男性患者,在接受大剂量化疗后进行自体干细胞移植和放射治疗后,复发的POEMS综合征合并骨浆细胞瘤,且新检测到17p缺失。他接受达雷妥尤单抗联合来那度胺和地塞米松(Dara-Rd)治疗成功。Dara-Rd可能对伴有17p缺失的复发POEMS综合征有效,17p缺失在多发性骨髓瘤中是一种已知的不良细胞遗传学异常。本报告可能会拓宽Dara-Rd在POEMS综合征中的应用。

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