PMID- 37702830 OWN - NLM STAT- MEDLINE DCOM- 20240118 LR - 20240207 IS - 1590-3478 (Electronic) IS - 1590-1874 (Print) IS - 1590-1874 (Linking) VI - 45 IP - 2 DP - 2024 Feb TI - Regular assessment of serum vascular endothelial growth factor levels to monitor POEMS syndrome. PG - 727-733 LID - 10.1007/s10072-023-07064-5 [doi] AB - 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 DeltamCRES 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. CI - (c) 2023. The Author(s). FAU - Gentile, Francesco AU - Gentile F AUID- ORCID: 0000-0002-1847-5608 AD - Neuromuscular and Neuroimmunology Unit, Department of Medical Biotechnology and Translational Medicine, IRCCS Humanitas Research Hospital, Milan University, Via Manzoni 56, 20089, Rozzano, Italy. AD - Neurology Residency Program, University of Milan, 20122, Milan, Italy. FAU - Terenghi, Fabrizia AU - Terenghi F AUID- ORCID: 0000-0002-4708-7380 AD - Neuromuscular and Neuroimmunology Unit, Department of Medical Biotechnology and Translational Medicine, IRCCS Humanitas Research Hospital, Milan University, Via Manzoni 56, 20089, Rozzano, Italy. FAU - Doneddu, Pietro Emiliano AU - Doneddu PE AUID- ORCID: 0000-0003-4203-6792 AD - Neuromuscular and Neuroimmunology Unit, Department of Medical Biotechnology and Translational Medicine, IRCCS Humanitas Research Hospital, Milan University, Via Manzoni 56, 20089, Rozzano, Italy. AD - Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Rozzano, Italy. FAU - De Lorenzo, Alberto AU - De Lorenzo A AUID- ORCID: 0000-0002-9479-9444 AD - Neuromuscular and Neuroimmunology Unit, Department of Medical Biotechnology and Translational Medicine, IRCCS Humanitas Research Hospital, Milan University, Via Manzoni 56, 20089, Rozzano, Italy. AD - Neurology Residency Program, University of Milan, 20122, Milan, Italy. FAU - Giannotta, Claudia AU - Giannotta C AUID- ORCID: 0000-0002-8175-3842 AD - Neuromuscular and Neuroimmunology Unit, Department of Medical Biotechnology and Translational Medicine, IRCCS Humanitas Research Hospital, Milan University, Via Manzoni 56, 20089, Rozzano, Italy. FAU - Giordano, Andrea AU - Giordano A AD - Neuromuscular and Neuroimmunology Unit, Department of Medical Biotechnology and Translational Medicine, IRCCS Humanitas Research Hospital, Milan University, Via Manzoni 56, 20089, Rozzano, Italy. AD - Neurology Residency Program, University of Milan, 20122, Milan, Italy. FAU - Mazza, Rita AU - Mazza R AUID- ORCID: 0000-0003-2999-3678 AD - Department of Medical Oncology and Hematology, Humanitas Cancer Centre, Humanitas Clinical and Research Hospital IRCCS, Rozzano, Italy. FAU - Nozza, Andrea AU - Nozza A AD - Department of Medical Oncology and Hematology, Humanitas Cancer Centre, Humanitas Clinical and Research Hospital IRCCS, Rozzano, Italy. FAU - Nobile-Orazio, Eduardo AU - Nobile-Orazio E AUID- ORCID: 0000-0003-2624-8138 AD - Neuromuscular and Neuroimmunology Unit, Department of Medical Biotechnology and Translational Medicine, IRCCS Humanitas Research Hospital, Milan University, Via Manzoni 56, 20089, Rozzano, Italy. eduardo.nobile@unimi.it. AD - Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy. eduardo.nobile@unimi.it. LA - eng PT - Journal Article DEP - 20230913 PL - Italy TA - Neurol Sci JT - Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology JID - 100959175 RN - 0 (Vascular Endothelial Growth Factor A) SB - IM MH - Humans MH - *Vascular Endothelial Growth Factor A MH - *POEMS Syndrome/diagnosis MH - Retrospective Studies MH - Recurrence PMC - PMC10791858 OTO - NOTNLM OT - Biomarker OT - Monitoring OT - Neuropathy OT - POEMS syndrome OT - Relapse OT - VEGF COIS- Pietro Emiliano Doneddu has received travel grants to attend scientific meetings from CSL Behring and Kedrion. Eduardo Nobile-Orazio reports personal fees for Advisory or Scientific Board from ArgenX, Belgium, Takeda, Italy and USA, CSL-Behring, Italy and USA, Janssen, USA, Kedrion, Italy, LFB, France, Roche, Switzerland, Sanofi, USA. The other authors declare no conflict of interest. EDAT- 2023/09/13 12:42 MHDA- 2024/01/18 06:42 PMCR- 2023/09/13 CRDT- 2023/09/13 11:18 PHST- 2023/06/29 00:00 [received] PHST- 2023/09/04 00:00 [accepted] PHST- 2024/01/18 06:42 [medline] PHST- 2023/09/13 12:42 [pubmed] PHST- 2023/09/13 11:18 [entrez] PHST- 2023/09/13 00:00 [pmc-release] AID - 10.1007/s10072-023-07064-5 [pii] AID - 7064 [pii] AID - 10.1007/s10072-023-07064-5 [doi] PST - ppublish SO - Neurol Sci. 2024 Feb;45(2):727-733. doi: 10.1007/s10072-023-07064-5. Epub 2023 Sep 13.