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- Title
Regular assessment of serum vascular endothelial growth factor levels to monitor POEMS syndrome.
- Authors
Gentile, Francesco; Terenghi, Fabrizia; Doneddu, Pietro Emiliano; De Lorenzo, Alberto; Giannotta, Claudia; Giordano, Andrea; Mazza, Rita; Nozza, Andrea; Nobile-Orazio, Eduardo
- Abstract
Background: To investigate the utility of regular serum VEGF (sVEGF) levels assessment in the monitoring of POEMS syndrome. Methods: We retrospectively reviewed data of 30 patients with POEMS syndrome whose sVEGF was tested regularly every 6 months. sVEGF levels after treatment were measured and correlated with disability (Overall Neuropathy Limitations Scale, ONLS), clinical impairment (measured with the modified Clinical Response Evaluation Scale, mCRES), and relapse-free survival. The ability of sVEGF to predict disease flares during remission and refractory disease was also analysed. Results: Patients with normalised serum VEGF levels (< 1000 pg/ml) at 6 months showed prolonged relapse-free survival (at 3-year 94% for complete VEGF response, 57% partial, 0% none, p < 0.001) and greater later clinical improvement (median ΔmCRES complete VEGF response -5 vs partial -4, p = 0.019, and vs no VEGF response -2, p = 0.006). After remission, the sensitivity of 6-month sVEGF monitoring in predicting clinical relapse was 58% with a specificity of 100%. In patients refractory to treatment, the sensitivity in predicting further clinical worsening was 15%. In addition, in 25% of the patients in remission and 16% of those refractory to therapy, sVEGF levels only increased at the time of relapse. Conclusions: Regular sVEGF assessment is a valid biomarker in the prediction of disease reactivation in POEMS syndrome and was particularly useful during the phase of remission.
- Subjects
VASCULAR endothelial growth factors; DISEASE remission
- Publication
Neurological Sciences, 2024, Vol 45, Issue 2, p727
- ISSN
1590-1874
- Publication type
Article
- DOI
10.1007/s10072-023-07064-5