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CyBorD: cyclophosphamide, bortezomib, and dexamethasone POEMS: polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes SDH: spontaneous subdural hemorrhage VEGF: vascular endothelial growth factor INTRODUCTION We present a 49-year-old man with sclerodermalike skin changes who had recurrent ascites, hypogonadism, splenomegaly, and polyneuropathy. Serum studies found an IgA monoclonal gammopathy and an elevated vascular endothelial growth factor (VEGF). Imaging found sclerotic bone lesions, and a bone marrow biopsy found plasma cells. Given the constellation of findings, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome was diagnosed. Although profoundly debilitated at time of diagnosis, he improved rapidly with cyclophosphamide, bortezomib, and dexamethasone (CyBorD) chemotherapy and, later, autologous peripheral blood stem cell transplantation.

A patient with POEMS syndrome responding to modified CyBorD chemotherapy as a bridge to autologous stem cell transplantation