StemCell Therapy

Results of a recent study suggest a possible role for tumor necrosis factor- (TNF-) in the development of peripheral neuropathy (PN) in patients with multiple myeloma (MM) treated with bortezomib. The studys results were published in the Annals of Hematology.

Inthis study, patients with MM (N=35) were given a maximum of 8 cycles ofbortezomib in addition to dexamethasone. Patients underwent tests of nervefunction, and their serum levels of TNF- were also measured. This study alsoincluded an analysis of the effects of an anti-TNF- monoclonal antibodytherapy in Wistar rats (N=36) that received bortezomib.

Evaluablepatients were stratified based on the cumulative dosages of bortezomib theyreceived. A total of 16 patients (48.5%) had cumulative dosages of less than 39mg/m2, and 17 (51.5%) each received 39 mg/m2 or more of bortezomib.

Amongpatients who received lower cumulative dosages of bortezomib, 43.8% (n=7)experienced PN, compared with an incidence of PN of 82.4% (n=14) among patientswho received 39 mg/m2 or more of bortezomib (P <.05).Grade 3 PN was reported for 2 patients in the higher-dose group.

Baselineserum TNF- levels did not significantly differ between patients whoexperienced PN and those who did not. With bortezomib treatment, TNF- levelsrose overall, but increases were most significant among patients who developedPN of grades 2 to 3. The investigators also reported that most patients withTNF- levels higher than 65 pg/mL had neuropathy symptoms.

Inthe rat model, poorer nerve conduction velocity and evidence of mechanicalallodynia appeared to be associated with bortezomib therapy. Among rats treatedwith bortezomib, however, treatment with the anti-TNF- monoclonal antibody wasassociated with less neurological dysfunction.

Developmentof new neuroprotective agents against TNF- may be a promising therapeuticstrategy to prevent the development of neuropathy, wrote the studyinvestigators in their report.

Reference

Zhao W, Wang W, Li X, et al. Peripheral neuropathy following bortezomib therapy in multiple myeloma patients: association with cumulative dose, heparanase, and TNF-. Ann Hematol. doi: 10.1007/s00277-019-03816-6

Read more from the original source:

Potential Link Between Tumor Necrosis Factor- and Peripheral Neuropathy Observed With Bortezomib Treatment in Multiple Myeloma - Oncology Nurse...

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