In a nutshell
This paper studied the impact of nerve damage in patients with multiple myeloma. This study concluded that more than half of patients reported experiencing symptoms of nerve damage.
Some background
Use of drugs such as thalidomide (Thalomid), lenalidomide (Revlimid) and bortezomib (Velcade) have improved outcomes for patients with multiple myeloma. However, treatment is associated with damage to nerves. This nerve damage limits the dose of the drug that can be taken. Damage to the nerves can cause pain and reduced sensation. While most patients have improvements after stopping treatment, up to 25% of patients experience persistent nerve damage. The frequency and effect of dose modifications on nerve damage is still unclear.
Methods & findings
156 patients with multiple myeloma completed a questionnaire about the symptoms they experienced. They were diagnosed with multiple myeloma at an average 3.3 years ago. 51% of patients received bortezmib, 47% received thalidomide, and 39% received lenalidomide.
92% of patients reported at least one symptom of nerve damage on the questionnaire. 53% of patients reported at least having one symptom of nerve damage that bothered them “quite a bit” or “very much” in the past week. Nerve damage symptoms that were most often reported during the past week were mainly sensation related. 30% of patients reported tingling toes or feet. 17% of patients reported tingling fingers or hands. 17% reported trouble opening bottles due to loss of strength in the hands. 40% of male patients reported difficulty getting an erection.
Treatment with thalidomide was associated with more reports of nerve damage. A higher total dose of thalidomide received was associated with more severe nerve damage. Nerve damage from treatment was not associated with age nor gender. It was also not associated with the time since last course of therapy or the number of previous therapies.
Overall, 65% of patients had their treatment dose changed. 31% of patients had their treatment dose changed mainly because of nerve damage.
The bottom line
The authors concluded that nerve damage was commonly reported by patients with multiple myeloma, particularly those treated with thalidomide.
Published By :
Annals of Hematology
Date :
Jan 23, 2017
