OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press72710.17650/1818-8346-2008-0-3-52-62СОПРОВОДИТЕЛЬНАЯ ТЕРАПИЯIncidence, characteristics, and treatments of peripheral neuropathy in multiple myeloma patients receiving bortezomib (velcade)Частота, характеристика и методы лечения периферической нейропатии у больных множественной миеломой, получающих бортезомиб (велкейд)BessmeltsevS. S.БессмельцевС. С.
Russian Federation
KaryaginaE. V.КарягинаЕ. В.
Russian Federation

Saint Petersburg

Санкт-Петербург

StelmashenkoL. VСтельмашенкоЛ. В.
Russian Federation
StepanovaN. V.СтепановаН. В.
Russian Federation

Санкт-Петербург

MachulaitenE. R.МачюлайтенеЕ. Р.
Russian Federation

Санкт-Петербург

SalogubG. N.СалогубГ. Н.
Russian Federation

Санкт-Петербург

SkorokhodI. A.СкороходИ. А.
Russian Federation
MedvedevaN. V.МедведеваН. В.
Russian Federation
PodoltsevaE. I.ПодольцеваЭ. И.
Russian Federation
MatyukhinaL. M.МатюхинаЛ. М.
Russian Federation
NizamutdinovaA. S.НизамутдиноваА. С.
Russian Federation

Saint Petersburg

Санкт-Петербург

AbdulkadyrovK. M.АбдулкадыровК. М.
Russian Federation
Russian Research Institute of Hematology and TransfusiologyФГУ Российский научно-исследовательский институт гематологии и трансфузиологииCity Hospital FifteenГородская больница №15Russian Research Institute of Hematology and TransfusiologyСанкт-Петербургский государственный медицинский университет им. И.П. ПавловаI.P. Pavlov Saint Petersburg State Medical UniversityСанкт-Петербургский государственный медицинский университет им. И.П. ПавловаCity Hospital Thirty OneГУЗ Городская больница №31Road Hospital, AOA “RZhD”НУЗ Дорожная клиническая больница ОАО РЖДAlexandrov HospitalГУЗ Александровская больница240820083526224112022241120222008https://oncohematology.abvpress.ru/ongm/article/view/727

The characteristics of peripheral neuropathy (PN), its incidence and a possibility of relieving in multiple myeloma (MM) patients receiving bortezomib are presented. A hundred and twenty-four patients with recurrent/refractory MM and 14 primary patients were followed up. PN more commonly occurred after 3—5 cycles of bortezomib therapy. Grade > 2 PN was observed in 29% of the patients. The cumulative dose of bortezomib was 15.6 to 26 mg/m2. After 6—8 cycles the incidence of PN was also high. There was a correlation between the cumulative dose of bortezomib and the incidence of PN (R = 0.927; p < 0.0009). A correlation was also found between the incidence of PN and prior vincristine-containing treatment regimens (VAD scheme). Overall, PN was identified in 54% of the patients. Treatment of PN with gabapentin, pregabalin, vitamins B, and α-lipoic acid was effective. PN resolved to the baseline levels or the patients’ condition improved in 72% of the patients, the median time taken for resolution or improvement being 114 days. It is necessary to reduce the dose of bortezomib or to discontinue the drug temporarily in order to relieve the symptoms of neuropathy.

Дана характеристика периферической нейропатии (ПН), отмечены частота ее развития и возможность купирования у больных множественной миеломой (ММ), получающих бортезомиб. Под наблюдением находились 124 больных с рецидивом/рефрактерностью ММ и 14 пациентов с впервые диагностированным заболеванием. ПН чаще возникала после проведения 3—5 циклов терапии бортезомибом. У 29% больных наблюдалась ПН > II степени. Кумулятивная доза бортезомиба колебалась от 15,6 до 26 мг/м2. После 6—8 циклов частота ПН была также высокой. Обнаружена корреляционная связь между кумулятивной дозой бортезомиба и частотой развития ПН (R=0,927; p<0,0009). Выявлена корреляционная зависимость между частотой ПН и применением ранее винкристинсодержащих (схема ВАД) режимов терапии. В целом ПН выявлена у 54% больных. В качестве лечения использовали габапентин, прегабалин, а также витамины группы В, α-липоевую кислоту. Улучшение состояния больных или полное купирование ПН наблюдалось у 72% больных с медианой времени 114 дней. Для снятия симптомов нейропатии необходимым является редукция дозы бортезомиба или его временная отмена.

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