Abstract
Peripheral neuropathy (PN) is one of the most common side effects of bortezomib therapy. The majority of bortezomib-related PN is a sensory neuropathy of mild to moderate degree, and is reversible after dose reduction or discontinuation. However, occasionally bortezomib-induced neuropathy can be severe and affects motor and/or autonomic nerves, and may be mediated by immune process. The role of immune modulation therapy in the management of bortezomib-induced PN was not well established. Here, we reported a case of bortezomib-induced severe PN that responded well to plasma exchange and steroid treatment.
Highlights
Bortezomib is a reversible proteasome inhibitor, and has been approved by the FDA for the treatment of multiple myeloma either in combination with other agents or as a single agent [1,2]
The neuropathy may be caused by direct toxic effect of bortezomib or through an immunologically mediated process [3,4,5,6,7]
At the time of discontinuation of prednisone, he was able to ambulate with a cane and currently his performance status is back to his status prior to bortezomib treatment
Summary
Bortezomib is a reversible proteasome inhibitor, and has been approved by the FDA for the treatment of multiple myeloma either in combination with other agents or as a single agent [1,2]. One of the common side effects associated with bortezomib therapy is PN [3,4,5,6,7]. The neuropathy may be caused by direct toxic effect of bortezomib or through an immunologically mediated process [3,4,5,6,7]. We reported our experience in managing a severe bortezomib-related PN with immune modulation treatment.
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