title: A pilot study of acupuncture in treating bortezomib-induced peripheral neuropathy in patients with multiple myeloma.
abstract: BACKGROUND
  Peripheral neuropathy is the dose limiting toxicity of bortezomib in patients with multiple myeloma (MM).
  
  
  OBJECTIVE
  To examine the safety, feasibility and efficacy of acupuncture in reducing bortezomib-induced peripheral neuropathy (BIPN) symptoms.
  
  
  METHODS
  Patients with MM experiencing persistent BIPN ≥grade 2 despite adequate medical intervention and discontinuation of bortezomib received 10 acupuncture treatments for 10 weeks (2×/week for 2 weeks, 1×/week for 4 weeks, and then biweekly for 4 weeks). Responses were assessed by the Clinical Total Neuropathy Score (TNSc), Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) questionnaire, and the Neuropathy Pain Scale (NPS). Repeated-measures analysis of variance was used to test for monotonic decline in scores on each of the measures. Serial serum levels of proinflammatory and neurotrophic cytokines were obtained at baseline and weeks 1, 2, 4, 8, and 14.
  
  
  RESULTS
  Twenty-seven patients with MM were enrolled in the trial. There were no adverse events associated with the acupuncture treatments. TNSc data were deemed invalid and therefore were not reported. At weeks 10 and 14, FACT/GOG-Ntx and NPS showed significant reduction suggesting decreased pain, and improved function (P values were <.0001 for both FACT/GOG-Ntx and NPS at weeks 10 and 14). However, nerve conduction studies did not significantly change between baseline assessment and end of study. There was no correlation in serum cytokines for responders versus none responders.
  
  
  CONCLUSIONS
  Acupuncture is safe, feasible and produces subjective improvements in patients' symptoms. A follow-up randomized controlled trial is warranted.
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA baot@mskcc.org.
authors.forename: Ting
authors.initials: T
authors.lastname: Bao
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Olga
authors.initials: O
authors.lastname: Goloubeva
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Pelser
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Porter
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: James
authors.initials: J
authors.lastname: Primrose
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hester
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Mariola
authors.initials: M
authors.lastname: Sadowska
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Rena
authors.initials: R
authors.lastname: Lapidus
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Medeiros
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Lixing
authors.initials: L
authors.lastname: Lao
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Dorsey
authors.affiliation: The University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Ashraf Z
authors.initials: AZ
authors.lastname: Badros
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects / Q000379:methods*; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001897:Boronic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D000069286:Bortezomib; D016207:Cytokines / Q000378:metabolism; D005240:Feasibility Studies; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D010147:Pain Measurement; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000628:therapy*; D010865:Pilot Projects; D011719:Pyrazines / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D016207:Cytokines; D011719:Pyrazines; D000069286:Bortezomib
keywords: acupuncture; bortezomib; multiple myeloma; peripheral neuropathy