Daratumumab-RD InductionSequential Autologous Stem Cell Transplantation for a new diagnosed case of POEMS Syndrome with 17p deletion solitary plasmacytoma of bone

Abstract

Background Daratumumab-based induction therapy and autologous stem cell transplantation (ASCT) are the recommended treatments for plasma cell tumors such as multiple myeloma and amyloidosis; however, few reports have examined the utility of this treatment strategy for POEMS syndrome with solitary plasmacytoma of the bone.Case presentation A patient presented with POEMS syndrome. Although myasthenia was the primary manifestation, POEMS was accompanied by a solitary plasmacytoma of the bone harboring a 17p13.1 deletion. The overall neuropathy limitations scale (ONLS) score was 5 for both upper limbs and 7 for both lower limbs. After four cycles of induction therapy with daratumumab (Dara) plus lenalidomide and dexamethasone (Rd) immunofixation electrophoresis became negative, and complete remission of hematological and vascular endothelial growth factor (HRCR & VCR) was achieved. Subsequently, he received local radiotherapy (DT 5000cGy/25f), high-dose chemotherapy combined with ASCT, two cycles of Dara-Rd consolidation, and lenalidomide (10 mg/day) as maintenance. He has remained in continuous HRCR and VCR for 18 months, with an ONLS score of 3 for both upper limbs and 2 on both lower limbs, thereby restoring independent walking.Conclusions Dara-Rd induction followed by radiotherapy and ASCT appears to be a safe, effective, and promising strategy for POEMS syndrome with an isolated plasma cell tumor of the bone.