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18 - Treatment of emergent peripheral neuropathy in plasma cell disorders

from Section 4 - Supportive therapies

Published online by Cambridge University Press:  18 December 2013

By
Charise Gleason ,
Melanie Watson  and
Sagar Lonial
Edited by
Stephen A. Schey ,
Kwee L. Yong ,
Robert Marcus  and
Kenneth C. Anderson
Stephen A. Schey
Affiliation:
Department of Haematology, King’s College Hospital, London
Kwee L. Yong
Affiliation:
Department of Haematology, University College Hospital, London
Robert Marcus
Affiliation:
Department of Haematology, King’s College Hospital, London
Kenneth C. Anderson
Affiliation:
Dana-Farber Cancer Institute, Boston
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Summary

Introduction

Peripheral neuropathy (PN) occurs due to damage, inflammation or dysfunction to the peripheral nervous system, most likely as a result of injury to axons, myelin sheaths or the cell bodies. The extent of impaired function depends on the type of nerves affected – motor, sensory or autonomic. The onset of symptoms is variable and can present gradually or in a more rapid fashion. Symptoms range from temporary numbness, tingling, paresthesias, sensitivity to touch and weakness to more severe symptoms ranging from burning pain, muscle wasting, and to the extent of paralysis[1,2]. Typically, the longest nerves in the extremities are first affected with symmetric length dependent spreading from distal to proximal nerves[3]. The most common clinical manifestation of PN occurs in a “stocking and glove” pattern and the patients may complain of losing hand grip by dropping things or having difficulty picking up small objects. Patients with autonomic symptoms may experience labile blood pressure changes, orthostatic hypotension, irregular heart rates, changes in gastrointestinal motility, swallowing or respiratory problems[2]. PN tends to have a severe impact on quality of life and functional abilities in cancer patients and can impact overall survival or severity of full dose effective therapy[1].

Type
Chapter
Information
Myeloma
Pathology, Diagnosis, and Treatment
 , pp. 245 - 254
Publisher: Cambridge University Press
Print publication year: 2013

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