| Title | Neuropathy in multiple myeloma treated with thalidomide: a prospective study. | | Author(s) | Plasmati R, Pastorelli F, Cavo M, Petracci E, Zamagni E, Tosi P, Cangini D, Tacchetti P, Salvi F, Bartolomei I, Michelucci R, Tassinari CA | | Institution | Dipartimento di Neuroscienze, Unità Operativa di Neurologia, Ospedale Bellaria, Bologna, Italy. rosaria.plasmati@ausl.bo.it | | Source | Neurology 2007 Aug 7; 69(6):573-81. | | MeSH | Action Potentials
Adult
Aged
Angiogenesis Inhibitors
Antineoplastic Agents
Female
Follow-Up Studies
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Multiple Myeloma
Muscle Weakness
Neoadjuvant Therapy
Neural Conduction
Paresthesia
Peripheral Nervous System Diseases
Prospective Studies
Remission Induction
Severity of Illness Index
Thalidomide
Transplantation, Autologous
| | Abstract | BACKGROUND: Thalidomide is effective as a first-line therapy for the treatment of multiple myeloma (MM), but its use is limited by peripheral neurotoxicity.
OBJECTIVE: To study the occurrence of both myeloma-related neuropathy and thalidomide-induced neuropathy in 31 patients with newly diagnosed MM.
METHODS: Clinical and electrophysiologic examinations were performed in 31 patients with newly diagnosed MM before and after 4 months of therapy with thalidomide (200 mg/day, total dose: 21 g) aimed at debulking MM, before autologous transplantation. After transplantation, the patients took thalidomide, 200 mg/day for another 3 months (total dose over three months: 18 g) and then underwent a final clinical and electrophysiologic checkup.
RESULTS: At baseline, four patients presented a mild sensorimotor peripheral neuropathy related to MM, which tended to worsen slightly during treatment with thalidomide. At the end of treatment, 83% of the patients had clinical and electrophysiologic evidence of a mild sensory rather than motor, axonal, length-dependent polyneuropathy, whereas 100% of the patients showed improvement to the basic pathology (>or=partial response).
CONCLUSIONS: Peripheral neuropathy, sometimes subclinical, and mild in our patients, is a common, early side effect of thalidomide therapy. The high doses (21 g) used in all patients for a relatively short time (4 months) rule out any correlations between neuropathy, total dose, and duration of treatment. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
| | PubMed ID | 17679676 |
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