Abstract:

Objective: To study the diagnostic value of nerve electrophysiological studies (NES) for Bortezomib-induced peripheral neuropathy (BiPN) in patients with multiple myeloma(MM). Methods: A total of 79 patients with MM treated with bortezomib based induction chemotherapy were enrolled. The baseline and post-treatment perpheral neuropathy（PN） was assessed by clinical adverse effects and NES, and the results between these two assessing methods were compared. Results: Thirty-one of 79 (39.2%) MM patients had baseline NES abnormalities before treated with bortezomib, of them 20 (64.5%) patients developed BiPN at last, and early and grade 2 or higher BiPN also concentrated in patients with abnormal baseline NES. Compared with bone marrow plasma cells, serum LDH, β₂ microglobulin and other prognostic related clinical and laboratory indices, abnormal baseline NES was the only index that had significant difference between groups having or not having BiPN ( χ²=6.410, P=0.011). After 4 courses of treatment, 33 patients were diagnosed as having BiPN, among them 25(75.8%) patients were diagnosed by clinical adverse effects and 17 (51.5%) patients by subsequent NES. There was no significant difference in positive rate between the two assessment methods ( χ²=3.803, P=0.051). Of the 33 patients diagnosed as having BiPN, the diagnostic results of clinical adverse effects and of subsequent NES were consistent in 9 patients (27.3%) and inconsistent in 24 cases (72.7%), the consistency between the two assessment methods was poor (r_n=0.220, P=0.051). Conclusions: Abnormal baseline NES has some value for the prediction of BiPN, however, clinical assessment is still important for BiPN, and subsequent NES can be served as a supplement for clinical assessment of BiPN.

Key words: Multiple myeloma, Peripheral neuropathy, Bortezomib, Nerve electrophysiology