Improvement of thyroid function in POEMS syndrome after combination therapy of lenalidomide and dexamethasone

Abstract

Hypothyroidism is the most common endocrine disorder in POEMS syndrome. In this single-center prospective study, 36 patients with newly diagnosed POEMS syndrome were treated with lenalidomide (10 mg daily for 21 days) and dexamethasone (40mg once per week) for 12 cycles. Hypothyroidism was demonstrated in 58.5% (24/41) at baseline, including 25% (6/24) of clinical hypothyroidism and 75% (18/24) of subclinical hypothyroidism. After 12-month treatment, the percentages of clinical hypothyroidism and subclinical hypothyroidism had decreased 11.8% and 27.2%, respectively. Percentage of euthyroidism had increased from 41.5% to 80.5%. There was a strong relation between VEGF response and thyroid function improvement (p = .028). Patients with clinical hypothyroidism at baseline had an inferior 1-year OS (50% vs. 100%, p < .043) than euthyroidism and subclinical hypothyroidism groups. Clinical hypothyroidism was associated with decreased overall survival and this combination treatment was effective in improving thyroid function in POEMS syndrome.

Keywords:

• Hypothyroidism
• POEMS syndrome
• lenalidomide
• VEGF

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2018.1485909.

Additional information

Funding

This work had been supported by the National Natural Science Foundation of China (no. 81570195), the Beijing Natural Science Foundation (no. 7142130), the Specialized Research Fund for the Doctoral Program of Higher Education (no. 2013110611000), CAMS Innovation Fund for Medical Sciences (CIFMS, no. 2016-I2M-1-002), and the National Key Research and Development Program of China (no. 2016YFC0901503).