Pathophysiology of drug-induce peripheral neuropathy in patients with multiple myeloma

J Physiol Pharmacol. 2018 Apr;69(2). doi: 10.26402/jpp.2018.2.02. Epub 2018 Jun 13.

Abstract

Multiple myeloma (MM) is a disease of unknown, complex etiology that affects primarily older adults. The course of the disease and the patients' survival time are very heterogeneous, but over the last decade, clear progress in the treatment of this incurable disease has been observed. Therapeutics that have proven to be highly effective include the immunomodulatory drug thalidomide and its newer analogs, lenalidomide and pomalidomide, as well as the proteasome inhibitors bortezomib and carfilzomib. However, the administration of some of the treatments, e.g., thalidomide or bortezomib, has also been associated with the occurrence of a serious and common adverse effect, drug-induced peripheral neuropathy. The mechanism of the development of the peripheral neuropathy is poorly understood. Nevertheless, one of its potential causes could be inadequate concentrations of crucial trophic factors, including neurotrophic and/or angiogenic factors, which are responsible for the proliferation, differentiation, survival and death of neuronal and nonneuronal cells.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Bortezomib / adverse effects*
  • Bortezomib / therapeutic use
  • Humans
  • MicroRNAs / metabolism
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / metabolism
  • Nerve Growth Factors / metabolism
  • Peripheral Nervous System Diseases / chemically induced*
  • Protease Inhibitors / adverse effects*
  • Protease Inhibitors / therapeutic use
  • Thalidomide / adverse effects*
  • Thalidomide / therapeutic use

Substances

  • Antineoplastic Agents
  • MicroRNAs
  • Nerve Growth Factors
  • Protease Inhibitors
  • Thalidomide
  • Bortezomib