Improvement of Painful Bortezomib-Induced Peripheral Neuropathy Following Acupuncture Treatment in a Case Series of Multiple Myeloma Patients

摘要

Background: Bortezomib-induced peripheral neuropathy (BIPN) is a common and severe dose-limiting side effect in multiple myeloma (MM) patients. Treatment with narcotics, antidepressants, and anticonvulsants are of limited value in reducing symptoms, and they have the potential for significant side effects. Acupuncture has been reported to be effective in treating neuropathic pain. There has been limited reporting on the effect of acupuncture in treating BIPN. Objective: The aim of this study was to report on the effect of acupuncture in treating BIPN. Design and Patients: This study was a retrospective case series of five MM patients experiencing painful BIPN. Intervention: The patients were treated with the same acupuncture protocol on a weekly basis, adjusted to twice a week or once every 2 weeks based on response. Treatment included insertion of disposable sterile acupuncture needles, which were retained for 25 minutes, at the following bilateral ear points: shen men, point zero, and two auricular points where electro-dermal signal was detected; and bilateral body acupuncture points: LI 4, TE 5, LI 11, ST 40, and Ba Feng in the upper and lower extremities. Main Outcome Measures: All patients were assessed for severity of painful BIPN using a 0-10 numeric pain scale, with one patient assessed using the Clinical Total Neuropathy Score, Functional Assessment of Cancer Therapy-Neurotoxicity questionnaire, and Neuropathy Pain Scale. Results: All five patients experienced immediate pain reduction after one acupuncture treatment. Two of three patients who had more than three acupuncture treatments experienced long-lasting pain reduction and function improvement. There were no adverse events associated with acupuncture. Conclusion: Acupuncture is a viable treatment option for MM patients experiencing painful BIPN. However, further prospective research is needed.