Analysis of efficacy and safety of subcutaneous injection of bortezomib in patients with POEMS syndrome

Abstract

Objective To evaluate the effectiveness and safety of subcutaneous injection of bortezomib in patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome. Methods Since January 2013, patients who were newly diagnosed with POEMS syndrome in hematology department of Xuanwu Hospital of Capital Medical University were given treatments with subcutaneous injection of bortezomib 1.3 mg/(m2·d) on day 1, 4, 8, 11 and dexamethasone 20 mg/d on day 1, 2, 4, 5, 8, 9, 11, 12 for a period of 28 days. The treatments included no more than 4 cycles. The effects and adverse reactions/events of the treatments were observed. Results Until April 2015, 6 patients with POEMS syndrome were admitted. These patients aged from 37 to 66 years included 1 male, 5 female. All patients first presented with polyneuropathy, accompanied by monoclonal gammopathy, organomegaly, edema, endocrinopathy and pigment in skins. Optic disc edema was found in 4 patients and 3 patients had bone lesions. After 2 to 4 cycles of treatments, peripheral neuropathy was improved in 5 patients. Monoclonal gammopathy disappeared in 5 patients. Organomegaly, edema, endocrinopathy and skin changes recovered to different degree in all 6 patients. Recovery of optic disc edema was found in all 4 patients. Adverse reactions/events happened in 6 patients during the therapy. Peripheral neuropathy of 1 and 2 grade were reported in 3 patients. Three patients developed 1 and 2 grade of gastrointestinal reactions during treatments. Three patients developed respiratory tract infection. One patient developed mild anemia. One patient developed abnormal liver function. No patient discontinued therapy because of adverse events. Conclusion Subcutaneous injection of bortezomib may be an effective and safe treatment for POEMS syndrome. Key words: Bortezomib; POEMS syndrome; Peripheral nerve injuries