Optimizing the management of treatment-related peripheral neuropathy in patients with multiple myeloma.
Toxicity of the nervous system can be a biproduct of the use of novel agents such as bortezomib or thalidomide, as well as conventional agents such as vincristine and cisplatin in patients with multiple myeloma. Peripheral neuropathy (PN) involving sensory and motor nerves has emerged as an important adverse event associated with several recently approved novel myeloma therapies. Although PN is seen with varying frequency, the proportion of patients with myeloma with persistence or resolution of PN after treatment is not well defined. Indeed, currently there are no comprehensive clinical data pertaining to the proportion of patients experiencing treatment delays or discontinuing therapies secondary to PN. Moreover, in the absence of peer guidelines, the prevention and management of therapy-related PN tends to be ad hoc. In addition, currently there are no standard safe and effective treatment approaches available for the management of PN. Appropriate dose reductions and dose modifications are critical to minimizing long-term morbidity and maintaining efficacy or patients in relapsed or induction setting. This mini-review addresses some of the recent concerted efforts directed toward optimizing the management of therapy-related PN in patients with multiple myeloma.
Reddy
G Kesava
GK
CIG Media Group, LP, Dallas, TX.
Mughal
Tariq I
TI
Lonial
Sagar
S