Neuropathy in multiple myeloma treated with thalidomide
2007; Lippincott Williams & Wilkins; Volume: 69; Issue: 6 Linguagem: Inglês
10.1212/01.wnl.0000267271.18475.fe
ISSN1526-632X
AutoresR. Plasmati, Francesca Pastorelli, Michèle Cavo, Elisabetta Petracci, Elena Zamagni, Patrizia Tosi, Delia Cangini, Paola Tacchetti, Fabrizio Salvi, Ilaria Bartolomei, Roberto Michelucci, C. A. Tassinari,
Tópico(s)Peripheral Neuropathies and Disorders
ResumoThalidomide is effective as a first-line therapy for the treatment of multiple myeloma (MM), but its use is limited by peripheral neurotoxicity.To study the occurrence of both myeloma-related neuropathy and thalidomide-induced neuropathy in 31 patients with newly diagnosed MM.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.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).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.
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