Document Detail


Neurological monitoring reduces the incidence of bortezomib-induced peripheral neuropathy in multiple myeloma patients.
MedLine Citation:
PMID:  20433602     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Bortezomib (BTZ) is a proteasome inhibitor approved in the treatment of multiple myeloma (MM). Bortezomib-induced peripheral neuropathy (BIPN) is an unpredictable dose-limiting adverse event in one-third of patients. In the present study, 58 relapsed/refractory MM patients treated with BTZ were analyzed. The study's aim was to compare BIPN incidence and severity between both groups and to identify risk factors of BIPN. Twenty-four MM patients were evaluated by a neurologist periodically during BTZ treatment in order to prevent high-grade BIPN. Thirty-five MM patients previously treated with BTZ were reviewed. Seven (29%) patients in the monitored group and 19 (56%) in the historical cohort developed BIPN (p = 0.044). In the univariate analysis, factors related to BIPN in the whole series were age, number of vincristine and BTZ cycles, lactate dehydrogenase and neurological monitoring. Multivariate analysis revealed that absence of neurological monitoring (Hazard Ratio [HR]: 4.94 IC 95% [1.31-18.68], p = 0.019) and prior treatment with vincristine (HR: 1.34 IC 95% [1.04-1.74], p = 0.026) were associated with greater risk of BIPN. Baseline total neuropathy score-clinical version (TNSc) was a good predictor of BIPN, with higher risk for patients with TNSc >2 (p = 0.038). Neurological monitoring is useful for diminishing BIPN. Neurological monitoring of patients with baseline TNSc >2 should be considered.
Authors:
Roser Velasco; Josep Petit; Victoria Clapés; Enric Verdú; Xavier Navarro; Jordi Bruna
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the peripheral nervous system : JPNS     Volume:  15     ISSN:  1529-8027     ISO Abbreviation:  J. Peripher. Nerv. Syst.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9704532     Medline TA:  J Peripher Nerv Syst     Country:  United States    
Other Details:
Languages:  eng     Pagination:  17-25     Citation Subset:  IM    
Affiliation:
Department of Neurology, Neuro-Oncology Unit of IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Antineoplastic Agents, Phytogenic / administration & dosage,  adverse effects,  therapeutic use
Boronic Acids / administration & dosage,  adverse effects*,  therapeutic use
Cohort Studies
Female
Humans
Incidence
L-Lactate Dehydrogenase / analysis
Male
Middle Aged
Multiple Myeloma / drug therapy*
Multivariate Analysis
Neurologic Examination*
Peripheral Nervous System Diseases / chemically induced*,  epidemiology,  prevention & control*
Protease Inhibitors / administration & dosage,  adverse effects*,  therapeutic use
Pyrazines / administration & dosage,  adverse effects*,  therapeutic use
Recurrence
Risk Factors
Severity of Illness Index
Vincristine / administration & dosage,  adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Phytogenic; 0/Boronic Acids; 0/Protease Inhibitors; 0/Pyrazines; 0/bortezomib; 57-22-7/Vincristine; EC 1.1.1.27/L-Lactate Dehydrogenase

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