Quantitative sensory findings in patients with bortezomib-induced pain.
Bortezomib (PS-341) is a newly developed proteosome inhibitor that shows extremely promising antineoplastic effects against a variety of neoplasias. Neuropathic pain is emerging as a major complication of bortezomib. Although clinical reports have appeared in the literature describing the general symptoms of bortezomib chemoneuropathy, specific quantitative sensory data that detail the sensory deficits that might yield insight to the primary afferent dysfunction contributing to this pain is lacking. In this report, it is shown that patients with bortezomib-induced neuropathic pain have significantly elevated touch detection threshold and slotted peg board time, impaired sharpness detection, and elevated thresholds for the detection of skin warming and heat pain. Patients also had increased reports of cold pain. These data indicate that bortezomib-induced neuropathy is associated with deficits in Abeta, Adelta, and C caliber primary afferent fibers.


CONCLUSIONS
This work demonstrates that pain induced by the chemotherapy drug bortezomib is accompanied by dysfunction in all fiber types in sensory nerves. Impaired Abeta and C sensory function also extends into areas of skin that are not perceived as affected by pain.
Cata
Juan P
JP
Department of Anesthesiology and Pain Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Weng
Han-Rong
HR
Burton
Allen W
AW
Villareal
Horatio
H
Giralt
Sergio
S
Dougherty
Patrick M
PM
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001897:Boronic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D000069286:Bortezomib; D002908:Chronic Disease; D003080:Cold Temperature; D005260:Female; D006358:Hot Temperature; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy; D010146:Pain / Q000139:chemically induced* / Q000503:physiopathology*; D010147:Pain Measurement / Q000187:drug effects; D017288:Pain Threshold / Q000187:drug effects; D011597:Psychomotor Performance / Q000187:drug effects / Q000502:physiology; D011719:Pyrazines / Q000009:adverse effects* / Q000627:therapeutic use; D012677:Sensation / Q000187:drug effects / Q000502:physiology; D012678:Sensation Disorders / Q000139:chemically induced / Q000503:physiopathology; D013697:Thermosensing / Q000187:drug effects; D014110:Touch / Q000187:drug effects
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib