@article{3089103,
    title = "Management of treatment-emergent peripheral neuropathy in multiple myeloma",
    author = "Richardson, P.G. and Delforge, M. and Beksac, M. and Wen, P. and Jongen, J.L. and Sezer, O. and Terpos, E. and Munshi, N. and Palumbo, A. and Rajkumar, S.V. and Harousseau, J.L. and Moreau, P. and Avet-Loiseau, H. and Lee, J.H. and Cavo, M. and Merlini, G. and Voorhees, P. and Chng, W.J. and Mazumder, A. and Usmani, S. and Einsele, H. and Comenzo, R. and Orlowski, R. and Vesole, D. and Lahuerta, J.J. and Niesvizky, R. and Siegel, D. and Mateos, M.-V. and Dimopoulos, M. and Lonial, S. and Jagannath, S. and Bladé, J. and Miguel, J.S. and Morgan, G. and Anderson, K.C. and Durie, B.G.M. and Sonneveld, P.",
    journal = "Leukemia Research",
    year = "2012",
    volume = "26",
    number = "4",
    pages = "595-608",
    issn = "0145-2126",
    doi = "10.1038/leu.2011.346",
    keywords = "amitriptyline;  baclofen;  bortezomib;  carfilzomib;  carmustine;  cisplatin;  cyclophosphamide;  delanzomib;  dexamethasone;  doxorubicin;  etoposide;  ketamine;  lenalidomide;  levacecarnine;  melphalan;  menthol;  prednisone;  salinosporamide A;  thalidomide;  thioctic acid;  tumor necrosis factor alpha;  vincristine, cancer patient;  cell death;  demyelination;  DNA repair;  drug withdrawal;  human;  hyperesthesia;  multiple cycle treatment;  multiple myeloma;  muscle weakness;  nerve fiber degeneration;  nerve injury;  neuralgia;  neuropathic pain;  nonhuman;  paresthesia;  peripheral neuropathy;  priority journal;  review;  single nucleotide polymorphism, Boronic Acids;  Early Diagnosis;  Humans;  Immunologic Factors;  Incidence;  Multiple Myeloma;  Peripheral Nervous System Diseases;  Proteasome Endopeptidase Complex;  Pyrazines;  Thalidomide",
    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. © 2012 Macmillan Publishers Limited All rights reserved."
}