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病例报告:DKRd方案治疗新诊断的POEMS综合征及文献综述

Case report: DKRd regimen in the treatment of newly diagnosed POEMS syndrome and literature review.

作者信息

Wang Jianchao, Liao Wensheng, Liu Zhongwen, Kong Dai

机构信息

Department of Surgery of Spine and Spinal Cord, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.

Department of Hematology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.

出版信息

Front Oncol. 2024 Aug 1;14:1417380. doi: 10.3389/fonc.2024.1417380. eCollection 2024.

DOI:10.3389/fonc.2024.1417380
PMID:39148901
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11324492/
Abstract

POEMS syndrome, characterized as a rare multisystem paraneoplastic syndrome, arises from plasma cell abnormalities. Coined by Bardwick in 1980, the acronym POEMS delineates the distinctive features of the syndrome: Peripheral nerve Lesions, Organomegaly, Endocrinopathy, Monoclonal gammopathy, and Skin changes. The prevalence of POEMS syndrome stands at approximately 0.3 per 100,000 individuals. Owing to its low prevalence and the paucity of prospective studies, current treatment approaches largely hinge on retrospective studies and revolve around the use of plasma cell-directed therapy typically used in multiple myeloma treatments. This article presents the pioneering case of utilizing a four-drug combination regimen of DKRd (daratumumab, carfilzomib, lenalidomide, and dexamethasone) as a first-line treatment. This is succeeded by induction therapy and subsequently, autologous hematopoietic stem cell transplantation. A comprehensive review of related literature is conducted.

摘要

POEMS综合征是一种罕见的多系统副肿瘤综合征,由浆细胞异常引起。1980年由巴德威克提出,首字母缩略词POEMS描绘了该综合征的显著特征:周围神经病变、器官肿大、内分泌病、单克隆丙种球蛋白病和皮肤改变。POEMS综合征的患病率约为每10万人中有0.3例。由于其患病率低且前瞻性研究匮乏,目前的治疗方法很大程度上依赖于回顾性研究,并且围绕通常用于多发性骨髓瘤治疗的浆细胞定向疗法展开。本文介绍了使用DKRd(达雷妥尤单抗、卡非佐米、来那度胺和地塞米松)四联方案作为一线治疗的首例病例。随后进行诱导治疗,接着是自体造血干细胞移植。并对相关文献进行了全面综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a1/11324492/0c45b3b42e91/fonc-14-1417380-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a1/11324492/9fa7432d42f4/fonc-14-1417380-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a1/11324492/8c04f8b59995/fonc-14-1417380-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a1/11324492/0c45b3b42e91/fonc-14-1417380-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a1/11324492/9fa7432d42f4/fonc-14-1417380-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a1/11324492/8c04f8b59995/fonc-14-1417380-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a1/11324492/0c45b3b42e91/fonc-14-1417380-g003.jpg

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本文引用的文献

1
POEMS syndrome: Update on diagnosis, risk-stratification, and management.POEMS综合征:诊断、风险分层及管理的最新进展
Am J Hematol. 2023 Dec;98(12):1934-1950. doi: 10.1002/ajh.27081. Epub 2023 Sep 21.
2
Daratumumab monotherapy for relapsed POEMS syndrome.达雷妥尤单抗单药治疗复发性POEMS综合征。
Am J Hematol. 2023 Nov;98(11):E291-E294. doi: 10.1002/ajh.27050. Epub 2023 Aug 7.
3
Daratumumab, carfilzomib, and pomalidomide for the treatment of POEMS syndrome: The Mayo Clinic Experience.达雷妥尤单抗、卡非佐米和泊马度胺治疗POEMS综合征:梅奥诊所的经验
Blood Cancer J. 2023 May 31;13(1):91. doi: 10.1038/s41408-023-00859-x.
4
Daratumumab-bortezomib-dexamethasone use in relapsed POEMS syndrome.达雷妥尤单抗-硼替佐米-地塞米松用于复发的POEMS综合征
EJHaem. 2022 Jun 5;3(3):1021-1024. doi: 10.1002/jha2.492. eCollection 2022 Aug.
5
POEMS Syndrome: Real World Experience in Diagnosis and Systemic Therapy - 108 Patients Multicenter Analysis.POEMS综合征:诊断与全身治疗的真实世界经验——108例患者的多中心分析
Clin Lymphoma Myeloma Leuk. 2022 May;22(5):297-304. doi: 10.1016/j.clml.2021.10.007. Epub 2021 Oct 31.
6
Bortezomib plus dexamethasone as first-line therapy for patients with POEMS syndrome.硼替佐米联合地塞米松作为 POEMS 综合征患者的一线治疗。
Ann Hematol. 2021 Nov;100(11):2755-2761. doi: 10.1007/s00277-021-04609-6. Epub 2021 Jul 31.
7
Endocrine Evaluation in POEMS Syndrome: A Cohort Study.POEMS 综合征的内分泌评估:一项队列研究。
Front Endocrinol (Lausanne). 2020 Oct 27;11:536241. doi: 10.3389/fendo.2020.536241. eCollection 2020.
8
Upfront Daratumumab With Lenalidomide and Dexamethasone for POEMS Syndrome.达雷妥尤单抗联合来那度胺和地塞米松一线治疗POEMS综合征
Hemasphere. 2020 May 21;4(3):e381. doi: 10.1097/HS9.0000000000000381. eCollection 2020 Jun.
9
Successful desensitization to pomalidomide in a patient with POEMS syndrome with delayed-type hypersensitivity to immunomodulatory imid drugs.一名患有POEMS综合征且对免疫调节性咪唑类药物存在迟发型超敏反应的患者成功实现对泊马度胺脱敏。
Leuk Lymphoma. 2019 Dec;60(12):3087-3089. doi: 10.1080/10428194.2019.1620945. Epub 2019 Jun 4.
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Leukemia. 2019 Apr;33(4):1023-1029. doi: 10.1038/s41375-019-0391-2. Epub 2019 Jan 30.