Managing treatment-related peripheral neuropathy in patients with multiple myeloma
Sara Grammatico, Laura Cesini, Maria Teresa Petrucci Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy Abstract: Peripheral neuropathy is one of the most important complications of multiple myeloma treatment. Neurological damage can be o...
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Dove Medical Press
2016
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oai:doaj.org-article:cf281389a70047ca822d9d53123f61dc2021-12-02T08:06:26ZManaging treatment-related peripheral neuropathy in patients with multiple myeloma1179-9889https://doaj.org/article/cf281389a70047ca822d9d53123f61dc2016-06-01T00:00:00Zhttps://www.dovepress.com/managing-treatment-related-peripheral-neuropathy-in-patients-with-mult-peer-reviewed-article-BLCTThttps://doaj.org/toc/1179-9889Sara Grammatico, Laura Cesini, Maria Teresa Petrucci Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy Abstract: Peripheral neuropathy is one of the most important complications of multiple myeloma treatment. Neurological damage can be observed at the onset of the disease, due to the effect of monoclonal protein or radicular compression, but more often is treatment related. Vinca alkaloids in the past era, and more recently, thalidomide and bortezomib are mainly responsible. Degeneration of dorsal root ganglion is common, prevalently related to angiogenesis inhibition and cytokine modulation in the case of thalidomide and inhibition of the ubiquitin proteasome system in the case of bortezomib. Sensory neuropathy and neuropathic pain are more common; motor neuropathy and autonomic damage are less frequently observed. Neurotoxicity often affects patient's quality of life and requires dose modification or withdrawal of therapy, with a possible effect on the overall response. A prompt recognition of predisposing factors (such as diabetes mellitus, alcohol abuse, vitamin deficiencies, or viral infections) and appearance of signs and symptoms, through a periodic neurological assessment with appropriate scales, is extremely important. Effective management of treatment at the emergence of peripheral neuropathy can minimize the incidence and severity of this complication and preserve therapeutic efficacy. Dose adjustment could be necessary during treatment; moreover, gabapentin or pregabalin, tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, carbamazepine, and opioid-type analgesics are suggested according to the pain severity. Some authors reported that patients who develop peripheral neuropathy during their multiple myeloma treatments presented a particular gene expression profile; therefore, future studies could be helpful for a better understanding of possible biological pathways underlying neurotoxicity. Keywords: neurotoxicity, thalidomide-induced peripheral neuropathy, bortezomib-induced peripheral neuropathyGrammatico SCesini LPetrucci MTDove Medical PressarticleNeurotoxicitythalidomide-induced peripheral neuropathybortezomib-induced peripheral neuropathyDiseases of the blood and blood-forming organsRC633-647.5ENBlood and Lymphatic Cancer: Targets and Therapy, Vol 2016, Iss Issue 1, Pp 37-47 (2016) |
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Neurotoxicity thalidomide-induced peripheral neuropathy bortezomib-induced peripheral neuropathy Diseases of the blood and blood-forming organs RC633-647.5 |
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Neurotoxicity thalidomide-induced peripheral neuropathy bortezomib-induced peripheral neuropathy Diseases of the blood and blood-forming organs RC633-647.5 Grammatico S Cesini L Petrucci MT Managing treatment-related peripheral neuropathy in patients with multiple myeloma |
| description |
Sara Grammatico, Laura Cesini, Maria Teresa Petrucci Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy Abstract: Peripheral neuropathy is one of the most important complications of multiple myeloma treatment. Neurological damage can be observed at the onset of the disease, due to the effect of monoclonal protein or radicular compression, but more often is treatment related. Vinca alkaloids in the past era, and more recently, thalidomide and bortezomib are mainly responsible. Degeneration of dorsal root ganglion is common, prevalently related to angiogenesis inhibition and cytokine modulation in the case of thalidomide and inhibition of the ubiquitin proteasome system in the case of bortezomib. Sensory neuropathy and neuropathic pain are more common; motor neuropathy and autonomic damage are less frequently observed. Neurotoxicity often affects patient's quality of life and requires dose modification or withdrawal of therapy, with a possible effect on the overall response. A prompt recognition of predisposing factors (such as diabetes mellitus, alcohol abuse, vitamin deficiencies, or viral infections) and appearance of signs and symptoms, through a periodic neurological assessment with appropriate scales, is extremely important. Effective management of treatment at the emergence of peripheral neuropathy can minimize the incidence and severity of this complication and preserve therapeutic efficacy. Dose adjustment could be necessary during treatment; moreover, gabapentin or pregabalin, tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, carbamazepine, and opioid-type analgesics are suggested according to the pain severity. Some authors reported that patients who develop peripheral neuropathy during their multiple myeloma treatments presented a particular gene expression profile; therefore, future studies could be helpful for a better understanding of possible biological pathways underlying neurotoxicity. Keywords: neurotoxicity, thalidomide-induced peripheral neuropathy, bortezomib-induced peripheral neuropathy |
| format |
article |
| author |
Grammatico S Cesini L Petrucci MT |
| author_facet |
Grammatico S Cesini L Petrucci MT |
| author_sort |
Grammatico S |
| title |
Managing treatment-related peripheral neuropathy in patients with multiple myeloma |
| title_short |
Managing treatment-related peripheral neuropathy in patients with multiple myeloma |
| title_full |
Managing treatment-related peripheral neuropathy in patients with multiple myeloma |
| title_fullStr |
Managing treatment-related peripheral neuropathy in patients with multiple myeloma |
| title_full_unstemmed |
Managing treatment-related peripheral neuropathy in patients with multiple myeloma |
| title_sort |
managing treatment-related peripheral neuropathy in patients with multiple myeloma |
| publisher |
Dove Medical Press |
| publishDate |
2016 |
| url |
https://doaj.org/article/cf281389a70047ca822d9d53123f61dc |
| work_keys_str_mv |
AT grammaticos managingtreatmentrelatedperipheralneuropathyinpatientswithmultiplemyeloma AT cesinil managingtreatmentrelatedperipheralneuropathyinpatientswithmultiplemyeloma AT petruccimt managingtreatmentrelatedperipheralneuropathyinpatientswithmultiplemyeloma |
| _version_ |
1718398691209904128 |