Multiple myeloma: Treatmentrelated peripheral neuropathy

摘要

Multiple myeloma (MM) is a B-cell malignancy that results in uncontrolled growth and division of plasma cells Harrousseau, 2002). Although incurable, new targeted treatments are extending survival rates. The proteasome inhibitor bortezomib, and immunomodulatory drug thalidomide are now central in anti-myeloma treatment (Delforge et al, 2010). However, their use has resulted in increasing rates of treatment-related peripheral neuropathy (PN), which can exacerbate any existing PN as a result of MM itself. Treatment-related PN is the leading cause of PN among myeloma patients (Mohty et al, 2010). PN is damage to peripheral nerves, which often causes numbness and pain to the hands and feet. Orthostatic hypotension, a symptom arising from damage to peripheral autonomic nerves, is present in about 10% of patients treated with bortezomib (Mohty et al, 2010). Orthostatic hypotension can be difficult to diagnose and manage; sometimes requiring withdrawal of treatment.