title: Subclinical pretreatment sensory deficits appear to predict the development of pain and numbness in patients with multiple myeloma undergoing chemotherapy.
abstract: OBJECTIVE
  Chemotherapy-induced peripheral neuropathy is a major complication in the treatment for cancer, including multiple myeloma (MM). Patients may develop painful and non-painful (e.g., numbness) neuropathy symptoms that impair function and often persist after therapy is terminated. This study tested the hypothesis that baseline subclinical neuropathy, as assessed by sensory thresholds, is related to the development of neuropathy symptoms (e.g., pain and numbness) in patients with MM undergoing treatment with chemotherapy.
  
  
  METHODS
  Patients (n = 56) who had undergone two or fewer cycles of induction therapy and who had no evident neuropathy were assessed using quantitative sensory tests to determine multiple-modality sensory thresholds. Patient-reported pain and numbness were assessed through induction therapy (16 weeks) via the MD Anderson Symptom Inventory. A subset of participants (n = 15) continued reporting on their symptoms for an additional 16 weeks ("maintenance phase").
  
  
  RESULTS
  Patients with sharpness detection deficits at baseline (n = 11, 20 % of sample) reported less severe pain and numbness during induction therapy and less numbness during maintenance therapy (P < 0.05). During the maintenance phase, patients with warmth detection deficits (n = 5, 38 % of sample) reported more severe pain and numbness, and those with skin temperature deficits (n = 7, 47 % of maintenance sample) reported more severe pain (P < 0.05). These deficits were related to patient reported difficulty walking, a common symptom of peripheral neuropathy.
  
  
  CONCLUSIONS
  Our results suggest that baseline subclinical sensory deficits may be related to a patient's risk for developing chemotherapy-induced peripheral neuropathy.
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Elisabeth G
authors.initials: EG
authors.lastname: Vichaya
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Boyette-Davis
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.forename: Zijing
authors.initials: Z
authors.lastname: He
authors.forename: Sheeba K
authors.initials: SK
authors.lastname: Thomas
authors.forename: Nina
authors.initials: N
authors.lastname: Shah
authors.forename: Loretta A
authors.initials: LA
authors.lastname: Williams
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Dougherty
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000139:chemically induced* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000139:chemically induced* / Q000523:psychology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000523:psychology; D011237:Predictive Value of Tests; D012684:Sensory Thresholds / Q000502:physiology; D011795:Surveys and Questionnaires
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