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Neuropathy Prevention in Myeloma
Neuropathy prevention in myeloma is essential. I say this because, according to research, more than 20% of newly diagnosed MM patients present with PN, and up to 75% of MM patients develop chemotherapy-induced peripheral neuropathy.
Because of the prevalence and seriousness of this side effect, I blog about possible therapies for CIPN when I come upon new therapies. The research linked below is one such new therapy for CIPN.
I linked the video below because it gives an all-around, basic explanation of CIPN.
Chemotherapy-induced Peripheral Neuropathy
I am a long-term MM survivor and MM cancer coach. If you have questions about CIPN, email me at David.PeopleBeatingCancer@gmail.com.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Methylcobalamin
Methylcobalamin is a cobalamin, a form of vitamin B₁₂. It differs from cyanocobalamin in that the cyano group at the cobalt is replaced with a methyl group. Methylcobalamin features an octahedral cobalt(III) centre and can be obtained as bright red crystals.
Glutathione combined with mecobalamin in the treatment of chemotherapy-induced peripheral neuropathy in multiple myeloma: a retrospective clinical study
Background: This study sought to examine the use of glutathione combined with mecobalamin in the prevention and treatment peripheral neuropathy (PN) in multiple myeloma (MM) patients, observe its effectiveness and safety, and explore the risk factors and prognostic factors of chemotherapy-induced peripheral neuropathy (CIPN)…
Results: The incidence of PN, especially grade 2 and 3 PN, was more decreased in the study group than the control group. The history of diabetes (P=0.032) and the method of bortezomib injection (P=0.043) was found to affect the PN grade. The multivariate logistic regression analysis showed that diabetes was an independent risk factor of PN in MM patients [odds ratio (OR) =3.484, P=0.020]. The Proportional hazards model multivariate analysis showed that extramedullary disease (EMD) [hazard ratio (HR) =2.373, P=0.006] and elevated lactic dehydrogenase (LDH) (HR =1.934, P=0.009) were independent prognostic factors for MM patients.
Conclusions: Glutathione combined with mecobalamin significantly reduced the incidence and severity of CIPN in MM patients, and did not increase the adverse reactions of patients with MM. Diabetes and bortezomib intravenously increased the incidence and severity of PN in patients with MM…
Adverse reactions
During treatment, blood biochemistry (liver, renal, and coagulation functions and electrolytes), electrocardiograms, and imaging examinations were routinely performed for all patients. If hepatic insufficiency occurred, patients in the study group were given oral medicine to enhance the hepatoprotective effects, and patients in the control group were intravenously administered hepatoprotective drugs other than glutathione.
If PN occurred, specific treatments were administered based on the severity of the reaction. If cytopenia occurred, granulocyte colony stimulating factor (G-CSF) or component blood transfusions were administered. If gastrointestinal symptoms occurred, antiemetic, acid suppression, gastrointestinal motility, and other drugs were administered.
If creatinine clearance increased, symptomatic kidney protection treatment was administered, and hemofiltration or dialysis was performed as necessary. If a patient experienced a fever, an anti-infection treatment was first administered and then pathogenic examination was performed to treat the symptoms…
Adverse reactions
There were no significant differences in the adverse reactions, such as leukopenia, thrombocytopenia, hemoglobin reduction, pulmonary infection/upper respiratory tract infections, digestive tract symptoms, herpes zoster or urinary tract infections, between the study and control groups (P>0.05). The incidence of PN was lower in the study group than the control group (31.6% vs. 41.7%), and the difference between grades 2 and 3 PN was statistically significant (P=0.048 and P=0.040, respectively)…
Conclusions
In this study, reduced glutathione combined with mecobalamin was used to treat MM-related PN, and was found to not only reduce the incidence of PN but also to reduce the severity of disease. It had no significant effect on disease remission, or the PFS or OS of patients. This drug combination also had a good safety profile.
Diabetes and intravenously administered bortezomib increases the incidence and severity of CIPN. Additionally, if reduced glutathione is combined with mecobalamin, blood glucose levels need to be controlled and bortezomib needs to be subcutaneously injected to reduce the incidence and severity of PN. In addition, this study showed that elevated EMD and LDH are independent prognostic factors of MM, and glutathione combined with mecobalamin improves patient prognosis.
Neuropathy prevention in myeloma Neuropathy prevention in myeloma Neuropathy prevention in myeloma