Keyword: VEGF
1 result found.
Original Article
Oncology, Nuclear Medicine and Transplantology, 2(3), 2026, onmt022, https://doi.org/10.63946/onmt/19021
ABSTRACT:
Introduction: POEMS syndrome is a rare paraneoplastic disorder associated with plasma cell dyscrasia and characterized by a combination of organomegaly, peripheral polyneuropathy, endocrinopathies, osteosclerotic lesions, monoclonal shedding, and typical skin changes. Diagnosis is challenging due to the nonspecific clinical presentation and minimal bone marrow infiltration. Currently, treatment approaches remain nonstandard, and the use of anti-CD38 therapy is limited.
Objective: To demonstrate the complexity and duration of diagnosis of POEMS syndrome and evaluate the clinical effect of anti-CD38 therapy.
Materials And Methods: A retrospective analysis of clinical, laboratory, and imaging data from a 38-year-old patient seen at the National Cancer Research Center was conducted. Diagnostic evaluation included serum enzyme-linked immunosorbent assay, vascular endothelial growth factor (VEGF) levels, PET/CT, bone marrow examination, and assessment of compliance with the Dispenzieri 2019 criteria. Treatment efficacy was assessed based on clinical symptoms and laboratory findings.
Results: The patient was diagnosed with polyneuropathy, organomegaly, extravascular fluid overload, endocrinopathy, monoclonal IgG-λ secretion, and significantly elevated VEGF levels. Minimal plasma cell infiltration was noted in the bone marrow. POEMS syndrome was diagnosed. Treatment with Daratumumab-Lenalidomide-Dexamethasone (Dara-RD) resulted in significant clinical improvement, decreased edema, and stabilization of laboratory parameters.
Conclusion: This case demonstrates the complexity of diagnosing POEMS syndrome with minimal bone marrow infiltration, severe systemic manifestations, and problems with long-term diagnostic verification, lasting for 5 years (from 2019 to 2025). Daratumumab-Lenalidomide-Dexamethasone (DaraRD) therapy has demonstrated significant clinical benefit and can be considered a progressive treatment option for severe forms of the disease.
Objective: To demonstrate the complexity and duration of diagnosis of POEMS syndrome and evaluate the clinical effect of anti-CD38 therapy.
Materials And Methods: A retrospective analysis of clinical, laboratory, and imaging data from a 38-year-old patient seen at the National Cancer Research Center was conducted. Diagnostic evaluation included serum enzyme-linked immunosorbent assay, vascular endothelial growth factor (VEGF) levels, PET/CT, bone marrow examination, and assessment of compliance with the Dispenzieri 2019 criteria. Treatment efficacy was assessed based on clinical symptoms and laboratory findings.
Results: The patient was diagnosed with polyneuropathy, organomegaly, extravascular fluid overload, endocrinopathy, monoclonal IgG-λ secretion, and significantly elevated VEGF levels. Minimal plasma cell infiltration was noted in the bone marrow. POEMS syndrome was diagnosed. Treatment with Daratumumab-Lenalidomide-Dexamethasone (Dara-RD) resulted in significant clinical improvement, decreased edema, and stabilization of laboratory parameters.
Conclusion: This case demonstrates the complexity of diagnosing POEMS syndrome with minimal bone marrow infiltration, severe systemic manifestations, and problems with long-term diagnostic verification, lasting for 5 years (from 2019 to 2025). Daratumumab-Lenalidomide-Dexamethasone (DaraRD) therapy has demonstrated significant clinical benefit and can be considered a progressive treatment option for severe forms of the disease.
