Objective To evaluate the efficacy and safety of autologous hematopoietic stem cell transplantation(AHSCT)for the treatment of POEMS syndrome.Methods Six patients with POEMS syndrome were treated with AHSCT following high-dose melphalan(HD-MEL)conditioning.The cohort consisted of 5 males and 1 female,with a median age of 48.5 years(range:35-65 years)at the time of transplantation.Three patients underwent peripheral blood stem cell mobilization using granulocyte colony-stimulating factor(G-CSF)combined with plerixafor,while the remaining three received cyclophosphamide(CTX)chemotherapy followed by G-CSF for mobilization.One patient received melphalan at a dose of 140 mg/m²,and five patients received 200 mg/m².The median number of infused mononuclear cells(MNC)was 5.6(range:2.5-30.3)×108/kg,and the median number of CD34+cells was 3.2(range:2.2-6.3)×106/kg.Result All six patients successfully underwent transplantation,with a median time to neutrophil and platelet engraftment of 10.5 days(range:10-14 days)and 14.5 days(range:12-23 days),respectively.Serum immunofixation electrophoresis showed M-protein negativity in 4 cases post-transplant,while 1 case did not achieve complete hematologic remission.All six patients exhibited normalization of vascular endothelial growth factor(VEGF)levels following transplantation.Additionally,peripheral neuropathy symptoms improved in all six patients post-transplant.Conclusion AHSCT following high-dose melphalan conditioning demonstrates promising efficacy and high safety in the treatment of POEMS syndrome,with a low transplantation-related mortality rate.
维普
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