POEMS syndrome is a complex puzzle that can present with symptoms pointing in every direction. The article explores how haematologist Dr Daryl Tan solves this puzzle by connecting disparate clues to guide diagnosis and lead life-changing treatment.
Patient stories often read like medical mysteries. For 39-year-old Ridza Salim, his journey involved puzzling symptoms like severe headaches, vision changes, and frequent falls, which eventually led to him needing a wheelchair. After consulting eight different specialists, the final diagnosis came from an unexpected direction: Haematology. He was diagnosed with the rare multi-system disorder known as POEMS syndrome.
Insights from Dr Daryl on POEMS syndrome
This is an English translation of Dr Daryl Tan’s interview, first published in Lianhe Zaobao on 30 September 2025. Read on to find out what POEMS syndrome is, and why a haematologist like Dr Daryl is often central to unlocking the diagnosis and leading the treatment.
What is POEMS Syndrome?
POEMS syndrome is not a disease of a single organ. It is a rare blood disorder caused by an abnormal plasma cell—the same cell involved in multiple myeloma—that triggers widespread effects throughout the body.
The acronym “POEMS” helps remember its key features:
- Polyneuropathy: Nerve damage causing weakness, numbness, and pain in the hands and feet.
- Organomegaly: Enlargement of organs like the liver or spleen.
- Endocrinopathy: Hormonal imbalances (e.g., thyroid, blood sugar).
- Monoclonal plasma cell disorder: The root cause—an abnormal protein produced by plasma cells.
- Skin changes: Such as darkening or thickening.
There is no single textbook case. Diagnosis requires a haematologist to connect these scattered clues from various specialties.
The Diagnostic Breakthrough: A Haematology Perspective
For Ridza, routine tests were inconclusive. The turning point came from specific blood tests that detected a high level of monoclonal protein. This key finding, combined with a PET-CT scan and a tissue biopsy, allowed our haematology team to confirm POEMS syndrome.
“As haematologists, we look for the ‘M’ in POEMS—the monoclonal gammopathy,” explains a Haematologist, Dr Daryl Tan. “This is the common thread that ties the disparate symptoms together. We often employ specialised tests, including Vascular Endothelial Growth Factor (VEGF) levels, which are a key driver of the disease’s symptoms.”
Haematological Approach to POEMS Syndrome Treatment
Since POEMS syndrome originates from abnormal plasma cells, treatment strategies are similar to those for multiple myeloma. The goal is to eradicate the problematic cells to halt the progression of the disease.
The most effective treatment for eligible patients is high-dose chemotherapy followed by an autologous stem cell transplant. This procedure involves using the patient’s own blood-forming stem cells to rebuild their immune system after intensive chemotherapy.
- Stem cell transplant is a demanding but potentially curative approach, suitable for patients whose age and overall physical condition allow for it. It requires careful monitoring for risks like infection.
- Following a transplant, patients often enter a maintenance therapy phase to keep the disease in remission.
Long-Term Management and the Role of Collaboration
Long-term care for POEMS syndrome focuses on recovery and monitoring. This includes:
- Physical therapy to rebuild strength and nerve function.
- Correcting endocrine imbalances with hormone replacement.
- Regular follow-ups to monitor for any signs of relapse.
Early diagnosis and a coordinated, multi-disciplinary approach are critical. If diagnosed too late, nerve and organ damage can become irreversible.
If you or a loved one has unexplained anemia or related symptoms, consider consulting a haematologist to explore possible causes and treatment options.
Meet Our Haematologist
Dr Daryl Tan Chen Lung
MBBS (Singapore), MRCP (UK), MMED (Int Med), FAMS (Haematology)
Dr Daryl Tan is a haematologist in Singapore with clinical interests in lymphoma, multiple myeloma, leukaemia, and other blood disorders. His care includes diagnosis, treatment planning, chemotherapy, targeted therapy, and immunotherapy.