@article{e15c5edab4e74ad78b106041311ed91b,
title = "Management of treatment-emergent peripheral neuropathy in multiple myeloma",
abstract = "Peripheral neuropathy (PN) is one of the most important complications of multiple myeloma (MM) treatment. PN can be caused by MM itself, either by the effects of the monoclonal protein or in the form of radiculopathy from direct compression, and particularly by certain therapies, including bortezomib, thalidomide, vinca alkaloids and cisplatin. Clinical evaluation has shown that up to 20% of MM patients have PN at diagnosis and as many as 75% may experience treatment-emergent PN during therapy. The incidence, symptoms, reversibility, predisposing factors and etiology of treatment-emergent PN vary among MM therapies, with PN incidence also affected by the dose, schedule and combinations of potentially neurotoxic agents. Effective management of treatment-emergent PN is critical to minimize the incidence and severity of this complication, while maintaining therapeutic efficacy. Herein, the state of knowledge regarding treatment-emergent PN in MM patients and current management practices are outlined, and recommendations regarding optimal strategies for PN management during MM treatment are provided. These strategies include early and regular monitoring with neurological evaluation, with dose modification and treatment discontinuation as indicated. Areas requiring further research include the development of MM-specific, patient-focused assessment tools, pharmacogenomic analysis of patient DNA, and trials to assess the efficacy of pharmacological interventions.",
keywords = "bortezomib, immunomodulatory drug, multiple myeloma, peripheral neuropathy, proteasome inhibitor, thalidomide",
author = "Richardson, {P. G.} and M. Delforge and M. Beksac and P. Wen and Jongen, {J. L.} and O. Sezer and E. Terpos and N. Munshi and A. Palumbo and Rajkumar, {S. V.} and Harousseau, {J. L.} and P. Moreau and H. Avet-Loiseau and Lee, {J. H.} and M. Cavo and G. Merlini and P. Voorhees and Chng, {W. J.} and A. Mazumder and S. Usmani and H. Einsele and R. Comenzo and R. Orlowski and D. Vesole and Lahuerta, {J. J.} and R. Niesvizky and D. Siegel and Mateos, {M. V.} and M. Dimopoulos and S. Lonial and S. Jagannath and J. Blad{\'e} and Miguel, {J. San} and G. Morgan and Anderson, {K. C.} and Durie, {B. G.M.} and P. Sonneveld",
note = "Funding Information: Paul G Richardson is an advisor for Millennium Pharmaceuticals, Celgene Corporation, Novartis Pharmaceuticals, Johnson & Johnson and Bristol Myers Squibb. Michel Delforge is a consultant for Janssen and Celgene. He has also received speaker{\textquoteright}s honoraria from these companies. Joost L Jongen has received personal compensation from Pfizer. Orhan Sezer has received honoraria from Amgen, Celgene, Janssen and Novartis. Dr Sezer has also received research funding from Janssen and Novartis. Antonio Palumbo has received honoraria from Celgene, Janssen-Cilag, Merck and Amgen, and is on an advisory committee for Celgene and Janssen-Cilag. Shaji Kumar has received research funding from Celgene, Millennium and Novartis. He is a consultant for Merck. Philippe Moreau has received honoraria from Celgene, Janssen and Millennium. Michele Cavo has received honoraria from Janssen, Celgene and Millennium. Peter Voorhees is on speaker bureaus for Celgene Funding Information: and Millennium. Wee Joo Chng has received honoraria from Janssen, Celgene and Novartis, and has received research funding from Janssen and Roche. Amitabha Mazumder is a consultant for Celgene and Millennium, and has also received honoraria from these companies. Hermann Einsele is on the speaker bureaus for Celgene, Novartis and Janssen-Cilag. Raymond Comenzo is a scientific advisor for Millennium and Onyx, and also a consultant for Neotope and Millennium. He has received research support from Celgene and Millennium. Robert Orlowski has received research funding from Celgene, Millennium and Johnson and Johnson. He is also on advisory boards for Celgene, Millennium, Centocor, Novartis, Cephalon and Onyx, and has received honoraria from these companies. Juan Jos{\'e} Lahuerta has received honoraria from Celgene and Janssen-Cilag. Ruben Niesvizky is a speaker and consultant for Celgene, Millennium, Onyx and Novartis. He has also received research support from these companies. David Siegel is on speaker bureaus for Celgene and Millennium. Maria-Victoria Mateos has received honoraria from Janssen, Celgene, Millennium and Novartis. Meletios Dimopoulos has received honoraria from Celgene, Ortho-Biotech and Millennium. Sagar Lonial is a consultant for Millennium, Celgene, Novartis, BMS, Merck and Onyx. Joan Blad{\'e} has received honoraria for lectures from Celgene and Jansen Cilag. He is also on advisory boards for these companies and has received grant support from the same. J{\'e}sus San Miguel is on advisory boards for Millennium, Janssen-Cilag and Celgene. Kenneth C Anderson is on advisory boards for Celgene, Millennium, Ony, BMS, Merck and Novartis. He is also the founder of Acetylon. Brian GM Durie is on advisory boards for Millennium, Celgene and Onyx. Pieter Sonneveld is on advisory boards for Janssen, Celgene, Onyx, Novartis and Millennium-Takeda. He has also received research support from Celgene and Janssen. The remaining authors declare no conflict of interest.",
year = "2012",
month = apr,
doi = "10.1038/leu.2011.346",
language = "English (US)",
volume = "26",
pages = "595--608",
journal = "Leukemia",
issn = "0887-6924",
publisher = "Nature Publishing Group",
number = "4",
}