1
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Prieto-Torres AE, Esparza-Albornoz AS, Ovalle-Roa NA, Pisciotti-Chajin I, Martinez-Cordero H. Monoclonal Gammopathy of Neurological Significance in a Patient With Chronic Lymphocytic Inflammation With Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS Syndrome): A Case Report of a Rare Entity. Cureus 2024; 16:e67386. [PMID: 39310528 PMCID: PMC11414138 DOI: 10.7759/cureus.67386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Paraproteinemias or monoclonal gammopathies constitute a broad spectrum of heterogeneous clonal disorders of plasma cells characterized by the secretion of monoclonal proteins of heavy or light chains and the development of symptoms associated with them through mechanisms independent of tumor burden. Specifically, peripheral neuropathies represent an increasingly recognized manifestation of these paraproteinemias. We report a case of a 71-year-old female who presented to the emergency department with clinical symptoms of perioral paresthesias associated with an ataxic gait that progressively compromised her functionality, eventually completely limiting her ability to walk. Initially diagnosed with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS syndrome), management with corticosteroids was initiated, leading to partial improvement. After comprehensive etiological studies ruled out common causes of peripheral neuropathy (PN), a monoclonal peak of immunoglobulin M (IgM) was detected. With the initiation of appropriate treatment, the patient progressively regained her ability to walk. Unfortunately, due to prolonged corticosteroid use, she developed osteoporosis and multiple fragility fractures, which again limited her mobility. CLIPPERS syndrome coexisting with monoclonal gammopathy is extremely rare, highlighting the importance of this report.
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Affiliation(s)
| | | | | | | | - Humberto Martinez-Cordero
- Hematology, Hospital Militar Central, Bogotá, COL
- Hematology, Instituto Nacional de Cancerología, Bogotá, COL
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2
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Suzuki D, Sato D, Kikuchi K, Suzuki T, Sugasawa K, Saito S, Uchimura F, Suzuki Y. Bing-Neel syndrome with a paravertebral mass. Am J Med Sci 2023; 366:316-320. [PMID: 37473959 DOI: 10.1016/j.amjms.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/10/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
Bing-Neel syndrome, a rare neurological complication of Waldenström macroglobulinemia, is caused by the direct infiltration of malignant lymphoplasmacytic cells into the central nervous system. We report a patient who presented with back pain, weakness, lower extremity numbness, and gait disturbance accompanied by immunoglobulin M paraproteinemia and lymphoplasmacytic lymphoma in the bone marrow. Thoracic and lumbar magnetic resonance imaging revealed a long paravertebral mass around the spinal column, but the direct infiltration could not be proven. The patient was diagnosed with possible Bing-Neel syndrome and managed with bendamustine and rituximab. After chemotherapy, the patient's neurological and radiological findings improved. Magnetic resonance imaging should be considered when the Bing-Neel syndrome diagnosis is unclear.
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Affiliation(s)
- Daisuke Suzuki
- Department of Neurology, Nihonkai General Hospital, Sakata, Yamagata, Japan.
| | - Daisuke Sato
- Department of Neurology, Nihonkai General Hospital, Sakata, Yamagata, Japan
| | - Kenji Kikuchi
- Department of Neurology, Nihonkai General Hospital, Sakata, Yamagata, Japan
| | - Takuma Suzuki
- Department of Hematology, Nihonkai General Hospital, Sakata, Yamagata, Japan
| | - Kunie Sugasawa
- Department of Hematology, Nihonkai General Hospital, Sakata, Yamagata, Japan
| | - Soichi Saito
- Department of Hematology, Nihonkai General Hospital, Sakata, Yamagata, Japan
| | - Fumiaki Uchimura
- Department of Radiology, Nihonkai General Hospital, Sakata, Yamagata, Japan
| | - Yoshihiro Suzuki
- Department of Neurology, Nihonkai General Hospital, Sakata, Yamagata, Japan
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3
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Kareem SS, Viswanathan N, Sahebjam S, Tran ND, Gatewood T, Tobon K, Baz R, Piña Y, Shain KH, Mokhtari S. Leukoencephalopathy During Daratumumab-Based Therapy: A Case Series of Two Patients with Multiple Myeloma. Onco Targets Ther 2022; 15:953-962. [PMID: 36097632 PMCID: PMC9464026 DOI: 10.2147/ott.s365657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Leukoencephalopathy in the setting of multiple myeloma (MM) is a rare demyelinating condition, with few reported cases in literature. Daratumumab is a CD38 targeted monoclonal antibody that has been widely used for the management of MM. In the absence of central nervous system (CNS) disease, many medication-induced leukoencephalopathy cases reported with MM, including daratumumab-induced, are associated with progressive multifocal leukoencephalopathy (PML) and John Cunningham (JC) virus. Currently, there are no reported cases of daratumumab-induced leukoencephalopathy among patients without CNS involvement or PML. We discuss 2 patients who developed leukoencephalopathy while receiving daratumumab-based therapy without evidence of PML or CNS disease. Both patients had baseline MRIs without significant white matter changes before daratumumab-based therapy. Patients began experiencing neurological deficits about 6 to 8 months after daratumumab-based therapy initiation. One patient passed away before being assessed for improvement of symptoms with daratumumab cessation. The second patient had some stabilization of symptoms after cessation; however, the leukoencephalopathy remained irreversible. As the class of anti-CD38 monoclonal antibodies expands in MM therapy, we highlight a potential treatment complication and the importance of detecting leukoencephalopathy early among patients receiving anti-CD38 therapy. We recommend vigilant monitoring of any new or worsening neurological symptoms to avoid serious complications of irreversible leukoencephalopathy.
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Affiliation(s)
- Syeda Saba Kareem
- Malignant Hematology Department, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Solmaz Sahebjam
- Neuro-Oncology Department, Moffitt Cancer Center, Tampa, FL, USA
| | - Nam D Tran
- Neuro-Oncology Department, Moffitt Cancer Center, Tampa, FL, USA
| | - Tyra Gatewood
- Neuro-Oncology Department, Moffitt Cancer Center, Tampa, FL, USA
| | - Katherine Tobon
- Malignant Hematology Department, Moffitt Cancer Center, Tampa, FL, USA
| | - Rachid Baz
- Malignant Hematology Department, Moffitt Cancer Center, Tampa, FL, USA
| | - Yolanda Piña
- Neuro-Oncology Department, Moffitt Cancer Center, Tampa, FL, USA
| | - Kenneth H Shain
- Malignant Hematology Department, Moffitt Cancer Center, Tampa, FL, USA.,Tumor Biology Department, Moffitt Cancer Center, Tampa, FL, USA
| | - Sepideh Mokhtari
- Neuro-Oncology Department, Moffitt Cancer Center, Tampa, FL, USA
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4
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Sokhi DS, Mithi CW, Ebrahim FA, Salyani A, Waa S, Riyat MS. Collet-Sicard syndrome due to concurrent extramedullary intracranial plasmacytoma and jugular venous sinus thrombosis in multiple myeloma. Clin Case Rep 2021; 9:e04457. [PMID: 34336210 PMCID: PMC8319375 DOI: 10.1002/ccr3.4457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 05/11/2021] [Accepted: 05/25/2021] [Indexed: 11/27/2022] Open
Abstract
In a patient with Collet-Sicard syndrome and multiple myeloma, both extramedullary plasmacytomas and internal jugular vein-sigmoid sinus thrombosis should be considered as they can coexist.
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Affiliation(s)
- Dilraj Singh Sokhi
- Department of Medicine, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Caroline Wangui Mithi
- Department of Medicine, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Farah Alnoor Ebrahim
- Department of Medicine, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Adil Salyani
- Department of Medicine, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Sheila Waa
- Department of Radiology, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Malkit Singh Riyat
- Department of Oncology and Haematology, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
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5
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Hypercalcemic Encephalopathy as an Initial Presentation of Multiple Myeloma. Case Rep Emerg Med 2020; 2020:4746865. [PMID: 32089905 PMCID: PMC7031711 DOI: 10.1155/2020/4746865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/14/2020] [Accepted: 01/20/2020] [Indexed: 11/30/2022] Open
Abstract
We report the case of an 84-year-old female presented to us with acute onset altered sensorium. On investigation, neurological and infectious causes were ruled out. On further evaluation, her serum calcium was found elevated (15.07 gm/dl). The diagnosis of hypercalcemic encephalopathy was made with the possibility of multiple myeloma due to raised total protein and globulin levels. Serum electrophoresis, immunofixation, and bone marrow examination confirmed the diagnosis of multiple myeloma. The patient was treated with bortezomib, dexamethasone, and lenalidomide. After 1 week, she improved with normalization of serum calcium. Herein, we highlight hypercalcemia as an important cause of encephalopathy. As our report suggests, metabolic encephalopathy can be the first presentation in multiple myeloma.
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6
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Rajan R, Gotur A, Dhawan R, Garg A. Immune-mediated chorea in a patient with kappa light-chain monoclonal gammopathy. ANNALS OF MOVEMENT DISORDERS 2020. [DOI: 10.4103/aomd.aomd_13_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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7
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Baumeister SH, Murad J, Werner L, Daley H, Trebeden-Negre H, Gicobi JK, Schmucker A, Reder J, Sentman CL, Gilham DE, Lehmann FF, Galinsky I, DiPietro H, Cummings K, Munshi NC, Stone RM, Neuberg DS, Soiffer R, Dranoff G, Ritz J, Nikiforow S. Phase I Trial of Autologous CAR T Cells Targeting NKG2D Ligands in Patients with AML/MDS and Multiple Myeloma. Cancer Immunol Res 2018; 7:100-112. [PMID: 30396908 DOI: 10.1158/2326-6066.cir-18-0307] [Citation(s) in RCA: 222] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/02/2018] [Accepted: 10/29/2018] [Indexed: 11/16/2022]
Abstract
NKG2D ligands are widely expressed in solid and hematologic malignancies but absent or poorly expressed on healthy tissues. We conducted a phase I dose-escalation study to evaluate the safety and feasibility of a single infusion of NKG2D-chimeric antigen receptor (CAR) T cells, without lymphodepleting conditioning in subjects with acute myeloid leukemia/myelodysplastic syndrome or relapsed/refractory multiple myeloma. Autologous T cells were transfected with a γ-retroviral vector encoding a CAR fusing human NKG2D with the CD3ζ signaling domain. Four dose levels (1 × 106-3 × 107 total viable T cells) were evaluated. Twelve subjects were infused [7 acute myeloid leukemia (AML) and 5 multiple myeloma]. NKG2D-CAR products demonstrated a median 75% vector-driven NKG2D expression on CD3+ T cells. No dose-limiting toxicities, cytokine release syndrome, or CAR T cell-related neurotoxicity was observed. No significant autoimmune reactions were noted, and none of the ≥ grade 3 adverse events were attributable to NKG2D-CAR T cells. At the single injection of low cell doses used in this trial, no objective tumor responses were observed. However, hematologic parameters transiently improved in one subject with AML at the highest dose, and cases of disease stability without further therapy or on subsequent treatments were noted. At 24 hours, the cytokine RANTES increased a median of 1.9-fold among all subjects and 5.8-fold among six AML patients. Consistent with preclinical studies, NKG2D-CAR T cell-expansion and persistence were limited. Manufactured NKG2D-CAR T cells exhibited functional activity against autologous tumor cells in vitro, but modifications to enhance CAR T-cell expansion and target density may be needed to boost clinical activity.
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Affiliation(s)
- Susanne H Baumeister
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.,Division of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Division of Pediatric Hematology-Oncology Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Joana Murad
- Celdara Medical, LLC, Lebanon, New Hampshire
| | - Lillian Werner
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Heather Daley
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Helene Trebeden-Negre
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Joanina K Gicobi
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Jake Reder
- Celdara Medical, LLC, Lebanon, New Hampshire
| | | | | | | | - Ilene Galinsky
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Heidi DiPietro
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kristen Cummings
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Nikhil C Munshi
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Richard M Stone
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Donna S Neuberg
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Robert Soiffer
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Glenn Dranoff
- Novartis BioMedical Institutes, Cambridge, Massachusetts
| | - Jerome Ritz
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Sarah Nikiforow
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts. .,Harvard Medical School, Boston, Massachusetts
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8
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Ibekwe E, Horsley NB, Jiang L, Achenjang NS, Anudu A, Akhtar Z, Chornenka KG, Monohan GP, Chornenkyy YG. Abducens Nerve Palsy as Initial Presentation of Multiple Myeloma and Intracranial Plasmacytoma. J Clin Med 2018; 7:jcm7090253. [PMID: 30177596 PMCID: PMC6162841 DOI: 10.3390/jcm7090253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/31/2018] [Indexed: 01/11/2023] Open
Abstract
Central Nervous System (CNS) involvement in multiple myeloma and/or multifocal solitary plasmacytoma is rare. Although they are unique entities, multiple myeloma (MM) and plasmacytoma represent a spectrum of plasma cell neoplastic diseases that can sometimes occur concurrently. Plasmacytomas very often present as late-stage sequelae of MM. In this case report, we report a 53-year-old female presenting with right abducens cranial nerve (CN) VI palsy as an initial presentation secondary to lesion of the right clivus.
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Affiliation(s)
- Elochukwu Ibekwe
- College of Medicine, University of Kentucky, Lexington, KY 40506, USA.
| | - Neil B Horsley
- College of Medicine, University of Kentucky, Lexington, KY 40506, USA.
| | - Lan Jiang
- College of Medicine, University of Kentucky, Lexington, KY 40506, USA.
| | | | - Azubuogu Anudu
- College of Medicine, University of Kentucky, Lexington, KY 40506, USA.
| | - Zeeshan Akhtar
- College of Medicine, University of Kentucky, Lexington, KY 40506, USA.
| | - Karina G Chornenka
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Gregory P Monohan
- Department of Hematology-Oncology, University of Kentucky Medical Center, Lexington, KY 40536, USA.
| | - Yevgen G Chornenkyy
- College of Medicine, University of Kentucky, Lexington, KY 40506, USA.
- Department of Molecular and Cellular Biochemistry, University of Kentucky, Lexington, KY 40536, USA.
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9
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Aquino CC, Connolly B, Lang AE. Smoldering Multiple Myeloma Associated Leukoencephalopathy Presenting with Holmes Tremor, Ataxia, and Pyramidal Syndrome. Mov Disord Clin Pract 2018; 5:433-435. [PMID: 30838297 DOI: 10.1002/mdc3.12623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/20/2018] [Accepted: 04/05/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- Camila Catherine Aquino
- The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic Toronto Western Hospital, UNH Toronto Canada.,Department of Neurology University of Utah Salt Lake City Utah USA
| | - Barbara Connolly
- The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic Toronto Western Hospital, UNH Toronto Canada.,Division of Neurology, Department of Medicine McMaster University Hamilton Ontario Canada
| | - Anthony E Lang
- The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic Toronto Western Hospital, UNH Toronto Canada
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10
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Monoclonal gammopathy with both nemaline myopathy and amyloid myopathy. Neuromuscul Disord 2017; 27:942-946. [PMID: 28606401 DOI: 10.1016/j.nmd.2017.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 04/23/2017] [Accepted: 05/05/2017] [Indexed: 11/23/2022]
Abstract
Monoclonal gammopathies due to plasma cell dyscrasias can induce diverse rare neuromuscular disorders. Deposition of monoclonal antibody light chains in skeletal muscle causes amyloid myopathy. Monoclonal gammopathy is occasionally associated with sporadic late-onset nemaline myopathy. Here we report a monoclonal gammopathy patient with both sporadic late-onset nemaline myopathy and amyloid myopathy. The diagnoses were based on immunofixation electrophoresis of urine, and serum for free light chain assay, Congo red staining and Thioflavin S staining of muscle biopsies, as well as immunohistochemical staining and electron-microscopic observation. Nemaline myopathy and amyloid myopathy can present in the same patient with monoclonal gammopathy.
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11
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Stamo АP, Grigorieva VN. [Clinical characteristics of pain syndrome in patients with multiple myeloma]. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:11-15. [PMID: 27845309 DOI: 10.17116/jnevro201611610111-15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To study pain syndrome characteristics in the trunk and extremities of patients with multiple myeloma (MM). MATERIAL AND METHODS The study involved 120 patients with MM, aged from 34 to 83 years. The duration of disease was 2-37 months. RESULTS AND CONCLUSION The pain syndrome of trunk and extremity localization was revealed in 94% patients, its intensity according to the VAS was 65.5±25.4 mm. At all stages of disease, moderate to severe pain, predominantly related to polyneuropathy (PNP), radiculopathy and osteodestruction, was more frequent. Radicular pain syndrome was revealed in 46% of all MM patients, and in the majority of cases (92%), there were bone destruction lesions. The character of pain in MM should be specified to optimize further management of the patient.
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Affiliation(s)
- А P Stamo
- Nizhnegorodskay State Medical Academy, Nizhny Novgorod, Russia
| | - V N Grigorieva
- Nizhnegorodskay State Medical Academy, Nizhny Novgorod, Russia
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12
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Grammatico S, Cesini L, Petrucci MT. Managing treatment-related peripheral neuropathy in patients with multiple myeloma. Blood Lymphat Cancer 2016; 6:37-47. [PMID: 31360079 PMCID: PMC6467335 DOI: 10.2147/blctt.s91251] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Peripheral neuropathy is one of the most important complications of multiple myeloma treatment. Neurological damage can be observed at the onset of the disease, due to the effect of monoclonal protein or radicular compression, but more often is treatment related. Vinca alkaloids in the past era, and more recently, thalidomide and bortezomib are mainly responsible. Degeneration of dorsal root ganglion is common, prevalently related to angiogenesis inhibition and cytokine modulation in the case of thalidomide and inhibition of the ubiquitin proteasome system in the case of bortezomib. Sensory neuropathy and neuropathic pain are more common; motor neuropathy and autonomic damage are less frequently observed. Neurotoxicity often affects patient's quality of life and requires dose modification or withdrawal of therapy, with a possible effect on the overall response. A prompt recognition of predisposing factors (such as diabetes mellitus, alcohol abuse, vitamin deficiencies, or viral infections) and appearance of signs and symptoms, through a periodic neurological assessment with appropriate scales, is extremely important. Effective management of treatment at the emergence of peripheral neuropathy can minimize the incidence and severity of this complication and preserve therapeutic efficacy. Dose adjustment could be necessary during treatment; moreover, gabapentin or pregabalin, tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, carbamazepine, and opioid-type analgesics are suggested according to the pain severity. Some authors reported that patients who develop peripheral neuropathy during their multiple myeloma treatments presented a particular gene expression profile; therefore, future studies could be helpful for a better understanding of possible biological pathways underlying neurotoxicity.
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Affiliation(s)
- Sara Grammatico
- Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy,
| | - Laura Cesini
- Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy,
| | - Maria Teresa Petrucci
- Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy,
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13
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Molloy S, Lai M, Pratt G, Ramasamy K, Wilson D, Quraishi N, Auger M, Cumming D, Punekar M, Quinn M, Ademonkun D, Willis F, Tighe J, Cook G, Stirling A, Bishop T, Williams C, Boszczyk B, Reynolds J, Grainger M, Craig N, Hamilton A, Chalmers I, Ahmedzai S, Selvadurai S, Low E, Kyriakou C. Optimizing the management of patients with spinal myeloma disease. Br J Haematol 2015; 171:332-43. [DOI: 10.1111/bjh.13577] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Sean Molloy
- Royal National Orthopaedic Hospital; London UK
| | | | - Guy Pratt
- Department of Haematology; Heart of England NHS Trust Foundation; Birmingham UK
| | - Karthik Ramasamy
- Department of Haematology; Oxford University Hospitals NHS Trusts; Oxford UK
| | - David Wilson
- St Luke's Radiology; St Luke's Hospital; Oxford UK
| | - Nasir Quraishi
- Centre for Spinal Studies and Surgery; Queen's Medical Centre; Nottingham UK
| | - Martin Auger
- Department of Haematology; Norfolk and Norwich University Hospital; Norwich UK
| | - David Cumming
- Trauma and Orthopaedics Department; Ipswich Hospital NHS Trust; Ipswich UK
| | - Maqsood Punekar
- Department of Haematology; Lancashire Teaching Hospitals NHS Foundations Trust; Preston UK
| | - Michael Quinn
- Department of Haematology; Belfast City Hospital; Belfast UK
| | - Debo Ademonkun
- Trauma and Orthopaedics Department; Ipswich Hospital NHS Trust; Ipswich UK
| | - Fenella Willis
- Department of Haematology; St Georges Hospital; London UK
| | - Jane Tighe
- Department of Haematology; Aberdeen Royal Infirmary; Aberdeen UK
| | - Gordon Cook
- St James’ Institute of Oncology; Leeds Teaching Hospitals NHS Trust; Leeds UK
| | | | - Timothy Bishop
- Centre for Clinical Haematology; Nottingham University Hospitals NHS Trust; Nottingham UK
| | - Cathy Williams
- Centre for Clinical Haematology; Nottingham University Hospitals NHS Trust; Nottingham UK
| | - Bronek Boszczyk
- Centre for Spinal Studies and Surgery; Queen's Medical Centre; Nottingham UK
| | - Jeremy Reynolds
- Spinal Unit; Oxford University Hospitals NHS Trust; Oxford UK
| | - Mel Grainger
- Royal Orthopaedic Hospital NHS Foundations Trust; Birmingham UK
| | - Niall Craig
- Orthopaedic Suite; Woodend Hospital; Aberdeen UK
| | - Alastair Hamilton
- Department of Orthopaedic Surgery; Musgrove Park Hospital; Belfast UK
| | - Isobel Chalmers
- Trauma and Orthopaedics Department; Ipswich Hospital NHS Trust; Ipswich UK
| | - Sam Ahmedzai
- Academic Unit of Supportive Care; Department of Oncology; University of Sheffield; Sheffield UK
| | | | | | - Charalampia Kyriakou
- Department of Haematology; Northwick Park Hospital and Department of Haematology and Stem Cell Transplantation; Royal Free Hospital; London UK
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14
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Stübgen JP. Lymphoma-associated dysimmune polyneuropathies. J Neurol Sci 2015; 355:25-36. [PMID: 26070654 DOI: 10.1016/j.jns.2015.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 05/05/2015] [Accepted: 06/01/2015] [Indexed: 12/24/2022]
Abstract
Lymphoma consists of a variety of malignancies of lymphocyte origin. A spectrum of clinical peripheral neuropathy syndromes with different disease mechanisms occurs in about 5% of lymphoma patients. There exists a complex inter-relationship between lymphoproliferative malignancies and autoimmunity. An imbalance in the regulation of the immune system presumably underlies various immune-mediated neuropathies in patients with lymphoma. This article reviews lymphoma and more-or-less well-defined dysimmune neuropathy subgroups that are caused by humoral and/or cell-mediated immune disease mechanisms directed against known or undetermined peripheral nerve antigens.
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Affiliation(s)
- Joerg-Patrick Stübgen
- Department of Neurology, Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY 10065-4885, USA.
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15
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An unusual cause of anemia and encephalopathy. Mediterr J Hematol Infect Dis 2015; 7:e2015036. [PMID: 25960864 PMCID: PMC4418384 DOI: 10.4084/mjhid.2015.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 04/06/2014] [Indexed: 01/09/2023] Open
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