What is the best first-line treatment for POEMS syndrome: autologous transplantation, melphalan and dexamethasone, or lenalidomide and dexamethasone?

ABSTRACT: POEMS syndrome is a rare plasma cell dyscrasia. This study compared the responses to and survival of 347 POEMS syndrome patients given three first-line treatment regimens: autologous stem cell transplantation (ASCT, N = 165) and melphalan + dexamethasone (MDex, N = 79), or lenalidomide + dexamethasone (LDex, N = 103). After a median 45-month follow-up, overall hematologic complete remission (CR_H) was 46.4%, vascular endothelial growth factor complete remission (CR_V) was 55.1%, and neurological remission (R_N) was 93.8%. CR_H was better with ASCT (49.7%) than with MDex (37.7%, p = 0.001). CR_V was better with ASCT (66.2%) than with MDex (38.5%, p = 0.001) or LDex (47.7%, p = 0.008). Differences in R_N achieved by three regimens (

SUBMITTER: Zhao H 

PROVIDER: S-EPMC6756085 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature