Neuropathy in multiple myeloma treated with thalidomide: A prospective study

R. Plasmati, F. Pastorelli, M. Cavo, E. Petracci, E. Zamagni, P. Tosi, D. Cangini, P. Tacchetti, F. Salvi, I. Bartolomei, R. Michelucci, C. A. Tassinari

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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 (≥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.

Original languageEnglish
Pages (from-to)573-581
Number of pages9
JournalNeurology
Volume69
Issue number6
DOIs
Publication statusPublished - Aug 2007

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ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Plasmati, R., Pastorelli, F., Cavo, M., Petracci, E., Zamagni, E., Tosi, P., Cangini, D., Tacchetti, P., Salvi, F., Bartolomei, I., Michelucci, R., & Tassinari, C. A. (2007). Neuropathy in multiple myeloma treated with thalidomide: A prospective study. Neurology, 69(6), 573-581. https://doi.org/10.1212/01.wnl.0000267271.18475.fe