treating POEMS syndrome

Treatment for POEMS syndrome has improved remarkably. 

Patients who have three or fewer skeletal lesions, and whose bone marrow biopsies don't show monoclonal plasma cells, may be able to have radiation for the skeletal lesions.

Other patients will need a systemic therapy. The options include

autologous stem cell transplant


lenalidomide (Revlimid) or thalidomide

bortezomib (Velcade)

Steroids may help for a while, but usually stop being effective.  Plasmapheresis and IVIG usually don't help. The few reports about bevacizumab (Avastin) are worrisome--some patients who also received other treatments improved, but some patients died; other treatments are more effective.

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