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Somatic and autonomic small fiber neuropathy induced by bortezomib therapy: an immunofluorescence study

Abstract

Bortezomib is a new chemotherapeutic agent approved for the treatment of relapsed/refractory and newly diagnosed multiple myeloma. One of the major side effects of bortezomib is a peripheral length-dependent sensory axonal neuropathy and, less frequently, a small fiber neuropathy. Autonomic symptoms like postural dizziness, syncope, diarrhoea, ileus, impotence and urinary disturbances have been reported, nevertheless, autonomic neuropathy has never been characterized. We describe by means of immunofluorescence, the involvement of autonomic skin nerve fibers in three patients with small fiber neuropathy induced by bortezomib treatment.

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References

  1. Field-Smith A, Morgan GJ, Davies FE (2006) Bortezomib (Velcade™) in the treatment of multiple myeloma. Ther Clin Risk Manag 2(3):271–279

    Google Scholar 

  2. Cata JP, Weng HR, Burton AW, Villareal H, Giralt S, Dougherty PM (2007) Quantitative sensory findings in patients with bortezomib-induced pain. J Pain 8(4):296–306

    PubMed  Article  CAS  Google Scholar 

  3. Cata JP, Weng HR, Lee BN, Reuben JM, Dougherty PM (2006) Clinical and experimental findings in humans and animals with chemotherapy-induced peripheral neuropathy. Minerva Anestesiol 72(3):151–169 (review)

    PubMed  CAS  Google Scholar 

  4. Argyriou AA, Iconomou G, Kalofonos HP (2008) Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature. Blood 112(5):1593–1599

    Google Scholar 

  5. Cavaletti G, Gilardini A, Canta A, Rigamonti L, Rodriguez-Menendez V, Ceresa C, Marmiroli P, Bossi M, Oggioni N, D’Incalci M, De Coster R (2007) Bortezomib-induced peripheral neurotoxicity: a neurophysiological and pathological study in the rat. Exp Neurol 204(1):317–325

    PubMed  Article  CAS  Google Scholar 

  6. Meregalli C, Canta A, Carozzi VA, Chiorazzi A, Oggioni N, Gilardini A, Ceresa C, Avezza F, Crippa L, Marmiroli P, Cavaletti G (2010) Bortezomib-induced painful neuropathy in rats: a behavioral, neurophysiological and pathological study in rats. Eur J Pain 14(4):343–350

    PubMed  Article  CAS  Google Scholar 

  7. Richardson PG, Xie W, Mitsiades C, Chanan-Khan AA, Lonial S, Hassoun H, Avigan DE, Oaklander AL, Kuter DJ, Wen PY, Kesari S, Briemberg HR, Schlossman RL, Munshi NC, Heffner LT, Doss D, Esseltine DL, Weller E, Anderson KC, Amato AA (2009) Single-agent bortezomib in previously untreated multiple myeloma: efficacy, characterization of peripheral neuropathy, and molecular correlations with response and neuropathy. J Clin Oncol 27(21):3518–3525

    Google Scholar 

  8. Perfetti V, Palladini G, Brunetti L, Sgarella A, Brugnatelli S, Gobbi PG, Corazza GR (2007) Bortezomib-induced paralytic ileus is a potential gastrointestinal side effect of this first-in-class anticancer proteasome inhibitor. Eur J Gastroenterol Hepatol 19(7):599–601

    Google Scholar 

  9. Gupta S, Pagliuca A, Devereux S, Mufti GJ, Schey S (2006) Life-threatening motor neurotoxicity in association with bortezomib. Haematologica 91(7):1001

    Google Scholar 

  10. Donadio V, Cortelli P, Elam M, Di Stasi V, Montagna P, Holmberg B, Giannoccaro MP, Bugiardini E, Avoni P, Baruzzi A, Liguori R (2010) Autonomic innervation in multiple system atrophy and pure autonomic failure. J Neurol Neurosurg Psychiatry 81(12):1327–1335

    Google Scholar 

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Correspondence to Maria Pia Giannoccaro.

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Giannoccaro, M.P., Donadio, V., Gomis Pèrez, C. et al. Somatic and autonomic small fiber neuropathy induced by bortezomib therapy: an immunofluorescence study. Neurol Sci 32, 361–363 (2011). https://doi.org/10.1007/s10072-010-0475-2

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  • DOI: https://doi.org/10.1007/s10072-010-0475-2

Keywords

  • Small fiber neuropathy
  • Bortezomib
  • Velcade
  • Autonomic neuropathy
  • Skin biopsy