Sujata P Thawani1, Kurenai Tanji, Eduardo A De Sousa, Louis H Weimer, Thomas H Brannagan. 1. *Department of Neurology, Columbia Neuropathy Research Center, The Neurological Institute of New York, Columbia University Medical Center, New York, NY; †Division of Neuropathology, Department of Pathology and Cell Biology, Neuromuscular Pathology Laboratory, Columbia University College of Physicians and Surgeons, New York, NY; ‡Division of Neuromuscular Medicine, Department of Neurology, The University of Oklahoma Health Sciences Center, Oklahoma, OK.
Abstract
OBJECTIVES: Bortezomib is a proteasome inhibitor that is frequently used for multiple myeloma and lymphoma. A sensory predominant axonal neuropathy is associated with bortezomib treatment but a demyelinating neuropathy is also described primarily based on electrodiagnostic findings. We report a series of patients treated with bortezomib who developed peripheral neuropathy and were found to have demyelinating features on electrodiagnostic testing. METHODS: Four patients who developed a bortezomib-induced peripheral neuropathy underwent electrophysiological testing, and 1 patient had a nerve biopsy. RESULTS: The four patients with bortezomib-induced peripheral neuropathy had demyelinating features on their electrophysiological testing. The nerve biopsy performed in 1 patient demonstrated a demyelinating component in a background of axonal degeneration. CONCLUSIONS: Although most toxic neuropathies are symmetrical axonal neuropathies, bortezomib is part of a small list of agents that may cause a demyelinating polyneuropathy and axonal degeneration. These findings have been confirmed by nerve biopsy.
OBJECTIVES:Bortezomib is a proteasome inhibitor that is frequently used for multiple myeloma and lymphoma. A sensory predominant axonal neuropathy is associated with bortezomib treatment but a demyelinating neuropathy is also described primarily based on electrodiagnostic findings. We report a series of patients treated with bortezomib who developed peripheral neuropathy and were found to have demyelinating features on electrodiagnostic testing. METHODS: Four patients who developed a bortezomib-induced peripheral neuropathy underwent electrophysiological testing, and 1 patient had a nerve biopsy. RESULTS: The four patients with bortezomib-induced peripheral neuropathy had demyelinating features on their electrophysiological testing. The nerve biopsy performed in 1 patient demonstrated a demyelinating component in a background of axonal degeneration. CONCLUSIONS: Although most toxic neuropathies are symmetrical axonal neuropathies, bortezomib is part of a small list of agents that may cause a demyelinating polyneuropathy and axonal degeneration. These findings have been confirmed by nerve biopsy.
Authors: Malik Bechakra; Mariska D Nieuwenhoff; Joost van Rosmalen; Geert Jan Groeneveld; Marjan Scheltens-de Boer; Pieter Sonneveld; Pieter A van Doorn; Chris I de Zeeuw; Joost Lm Jongen Journal: Mol Pain Date: 2018 Jan-Dec Impact factor: 3.395