Successful hematopoietic stem-cell transplantation in multicentric Castleman disease complicated by POEMS syndrome
Successful hematopoietic stem-cell transplantation in multicentric Castleman disease complicated by POEMS syndrome
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DOI：
10.1002/ajh.20280
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发表时间：
2005-07-01
影响因子：
12.8
通讯作者：
Tarantolo, S
中科院分区：
文献类型：
--
作者：
Ganti, AK;Pipinos, I;Tarantolo, S
一个39岁的男性表现为足部水肿，胸腔积液，脾肿大，和全身性淋巴结病。血清蛋白电泳证实存在单克隆蛋白。脾切除术后脾脏的组织学检查显示多灶性血管增生和血管病变与多中心Castleman病一致。他接受了类固醇和利妥昔单抗治疗，但没有好转。发现患者有门静脉血栓形成和下肢动脉血栓形成。随后，他接受了环磷酰胺和米托蒽醌联合化疗，但出现了严重的炎症性多神经病变，使他残疾并不得不坐在轮椅上。诊断为多中心Castleman病伴POEMS综合征，随后接受大剂量美法兰化疗，随后进行自体外周血干细胞移植。移植后，他的神经传导研究改善，血清蛋白电泳正常。他目前可以走动，不需要轮椅辅助。造血干细胞移植可能是多中心Castleman病和POEMS综合征患者的治疗选择。(c) 2005 Wiley-Liss, Inc。
A 39-year-old male presented with pedal edema, pleural effusion, splenomegaly, and generalized lymphadenopathy. Serum protein electrophoresis demonstrated the presence of a monoclonal protein. Histological examination of the spleen following splenectomy showed multifocal vascular proliferation and angiovascular lesions consistent with multicentric Castleman disease. He was treated with steroids and rituximab, but without improvement. The patient was found to have portal venous thrombosis and lower extremity arterial thrombosis. He then received combination chemotherapy with cyclophosphamide and mitoxantrone but developed a severe inflammatory polyneuropathy that left him disabled and wheelchair-bound. A diagnosis of multicentric Castleman disease with POEMS syndrome was made, and he then received high-dose chemotherapy with melphalan followed by autologous peripheral blood stem-cell transplantation. Following transplantation, his nerve conduction studies improved and his serum protein electrophoresis normalized. He is currently ambulatory and does not need wheelchair assistance. Hematopoietic stem-cell transplantation may be a treatment option for patients with multicentric Castleman disease and POEMS syndrome. (c) 2005 Wiley-Liss, Inc.