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引用次数: 0
摘要
POEMS 综合征是一种浆细胞肿瘤,表现为周围神经病变、器官肿大、体液潴留、皮肤表现、骨硬化病变和 λ 型 M 蛋白血症。POEMS 综合征的发病机制尚不十分清楚,因为 POEMS 综合征中浆细胞的遗传特征与骨髓瘤不同。在大多数情况下,POEMS 综合征很难与慢性炎症性脱髓鞘性多发性神经病(CIDP)区分开来。因此,一定不要错过 POEMS 综合征的特征性体征,如 M 蛋白、血管内皮生长因子、胸腔积液和骨硬化病变。治疗骨髓瘤的新型药物,如沙利度胺、来那度胺和硼替佐米,都很有效。对于年轻患者,标准的治疗方法是在使用这些药物后进行自体移植,并同时使用大剂量美法仑。在长期观察的结果中,复发的病例越来越多,因此必须制定针对复发疾病的治疗策略。
POEMS syndrome is a plasma cell neoplasm that presents with peripheral neuropathy, organomegaly, fluid retention, skin manifestations, osteosclerotic lesions, and λ-type M-proteinemia. The pathogenesis of POEMS syndrome is poorly understood, as the genetic profile of plasma cells in POEMS syndrome differs from that of myeloma. In most cases, POEMS syndrome is difficult to distinguish from chronic inflammatory demyelinating polyneuropathy (CIDP). Consequently, it is essential not to miss characteristic signs of POEMS syndrome such as M-protein, VEGF, pleural effusion, and osteosclerotic lesions. Novel agents for myeloma, such as thalidomide, lenalidomide, and bortezomib, are effective. For younger patients, these agents followed by autologous transplantation with high-dose melphalan is the standard of care. More relapses are now being reported in results of long-term observation, and treatment strategies for relapsed disease must be established.