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Chemotherapy-induced peripheral neuropathies in hematological malignancies

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Abstract

Recent developments in the treatment of hematological malignancies, especially with the advent of proteasome inhibitors and immunomodulatory drugs in plasma cell dyscrasias, call for an increased collaboration between hematologists and neurologists. This collaboration involves differentiating chemotherapy-induced peripheral neuropathies (CiPN) from disease-related neurologic complications, early recognition of CiPN and treatment of neuropathic pain. Multiple myeloma, Waldenstrom’s macroglobulinemia and light-chain amyloidosis frequently present with peripheral neuropathy. In addition, multiple myeloma, non-Hodgkin lymphomas and leukemia’s may mimic peripheral neuropathy by compression or invasion of the extra/intradural space. Platinum compounds, vinca alkaloids, proteasome inhibitors and immunomodulatory drugs may all cause CiPN, each with different and often specific clinical characteristics. Early recognition, by identifying the distinct clinical phenotype of CiPN, is of crucial importance to prevent irreversible neurological damage. No recommendations can be given on the use of neuroprotective strategies because of a lack of convincing clinical evidence. Finally, CiPN caused by vinca-alkaloids, proteasome inhibitors and immunomodulatory drugs is often painful and neurologists are best equipped to treat this kind of painful neuropathy.

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Acknowledgments

Supported by a clinical research grant from the European Hematology Association, EMCR Translational Research Grant, Janssen Orthobiotech, and Multiple Myeloma Stem cell Network of the European Myeloma Network.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Erasmus MC, ‘s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Joost Louis Marie Jongen

  2. Department of Hematology, Erasmus MC Cancer Institute, ‘s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Annemiek Broijl & Pieter Sonneveld

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  1. Joost Louis Marie Jongen
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Correspondence to Joost Louis Marie Jongen.

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Jongen, J.L.M., Broijl, A. & Sonneveld, P. Chemotherapy-induced peripheral neuropathies in hematological malignancies. J Neurooncol 121, 229–237 (2015). https://doi.org/10.1007/s11060-014-1632-x

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