Several conditions. most commonly Castleman’s with about 30% of cases, can be associated with polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes (POEMS) syndrome, or it can present by itself. High-dose chemotherapy with autologous peripheral blood stem cell transplantation (ASCT) has been reported in case reprots and there are no prospective trials and it can cause considerable peritransplant morbidity. IN 2005 Dr. Dizspenzieri reported 16 cases with Castleman’s who had transplantation and 11 others from the literature; several more cases were subsequently also published.
There are no expert assessment, guidelines or consensus statements, policy statements or formal technology assessments. There are no trials published in peer-reviewed litrature. On the other hand, Castleman’s Disease is listed as a “rare disease” by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH), and such studies are not expected.
One cannot state with certainty that this procedure is efective, since it has never been prospectively studied in a trial. On the other hand, there are many case reports and the impression they provide that it may be of benefit.
An interesting association that one sometimes encounters is POEMS on the background of myeloma or palsmacytomas. In such a case, treating the underlying myeloma with autologous stem cell transplantation appears reasonable.
Sapar Kishor Ganti at al successful hematopoietic stem-cell transplantation in multicentric Castleman disease complicated by POEMS syndrome American Journal of Hematology Volume 79 Issue 3, Pages 206 – 210
Angela Dispenzieri, Alvaro Moreno-Aspitia, Guillermo A. Suarez, Martha Q. Lacy, Gerardo Colon-Otero, Ayalew Tefferi, Mark R. Litzow, Vivek Roy, William J. Hogan, Robert A. Kyle, and Morie A. Gertz
Peripheral blood stem cell transplantation in 16 patients with POEMS syndrome, and a review of the literature
Blood 104: 3400-3407, 2011
Apar Kishor Ganti, Iraklis Pipinos, Eliad Culcea, James O. Armitage, Stefano Tarantolo
Successful hematopoietic stem-cell transplantation in multicentric Castleman disease complicated by POEMS syndrome American Journal of Hematology Volume 79 Issue 3, Pages 206 – 210
M Ogita, J Hoshino, Y Sogawa, N Sawa, H Katori, F Takemoto, Y Ubara, S Hara, S Miyakoshi, K Takaichi Multicentric Castleman disease with secondary AA renal amyloidosis, nephrotic syndrome and chronic renal failure, remission after high-dose melphalan and autologous stem cell transplantation.
Clin Nephrol. 2007 Sep ;68 (3):171-6 17915620 (P,S,E,B)