Marked recovery of severe renal lesions in POEMS syndrome with high-dose melphalan therapy supported by autologous blood stem cell transplantation

Satoru Sanada, Susumu Ookawara, Hiroki Karube, Tetsuro Shindo, Toshikazu Goto, Takashi Nakamichi, Mikio Saito, Mitsunobu Matsubara, Masayuki Suzuki

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

POEMS syndrome is a rare plasma cell disorder, characterized by polyneuropathy, organomegaly, endocrinopathy, serum monoclonal protein, and skin lesions. Although not included in the acronym, renal lesions also are characteristic of this disease and sometimes require dialysis therapy. We treated a 61-year-old woman with POEMS syndrome with high-dose melphalan therapy (HDT) supported by autologous blood stem cell transplantation (SCT), and clinical remission was achieved. A repeated renal biopsy showed the striking effectiveness of this therapy on renal lesions. Pathological features of the renal lesions, such as membranoproliferative glomerulonephritis-like lesions, microangiopathic glomerulopathy, and mesangiolytic lesions with microcapillaries, almost completely disappeared. This treatment also markedly decreased serum levels of vascular endothelial growth factor (VEGF). These findings indicate that HDT with SCT is effective, even on renal lesions in patients with POEMS syndrome, and suggest that high serum VEGF concentrations are associated closely with the development of renal lesions in patients with this type of plasma cell disorder.

Original languageEnglish
Pages (from-to)672-679
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume47
Issue number4
DOIs
Publication statusPublished - 2006 Apr 1

Keywords

  • Autologous blood stem cell transplantation
  • High-dose melphalan
  • Polyneuropathy, organomegaly, endocrinopathy, serum monoclonal protein, and skin lesion (POEMS) syndrome
  • Renal biopsy
  • Vascular endothelial growth factor (VEGF)

ASJC Scopus subject areas

  • Nephrology

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