PERIPHERAL NEUROPATHY: ASSOCIATION WITH AGE AND SURVIVAL IN MULTIPLE MYELOMA PATIENTS

KAMILE SILAY¹, SEMA AKINCI², ARIFE ULAS³, TEKIN GUNEY², AHMET YALCIN⁴, IMDAT DILEK⁵

¹Yildirim Beyazit University, Faculty of Medicine, Ataturk Training and Research Hospital, Department of Internal Medicine and Geriatrics, Ankara - ²Ataturk Training and Research Hospital, Department of Hematology, Ankara - ³Ataturk Training and Research Hospital, Department of Medical Oncology, Ankara - ⁴Ataturk Training and Research Hospital, Department of Geriatrics, Ankara - ⁵Yildirim Beyazit University, Faculty of Medicine, Ataturk Training and Research Hospital, Department of Hematology, Ankara, Turkey

Objective: Multiple myeloma (MM) accounts for approximately 1% of all cancers and 10% of hematologic malignancies. Peripheral neuropathy (PN) is a common side effect of cancer therapy that can have an impact on quality of life and survivorship. PN may happen in MM due to adverse effect of chemotherapeutics, amyloidosis or as a part of paraneoplastic syndrome. The aim of this study is to evaluate the prevalence of peripheral neuropathy in multiple myeloma patients and its association with age and disease outcome.

Materials and methods: We conducted a retrospective review of 92 multiple myeloma patients who presented to hematology clinic between 2009 and 2014. Their age, gender, performance status, chemotherapeutic regimens, stage of disease, diabetes status and electromyography results were noted. An association between clinical parameters and neuropathy was analyzed. Kaplan Meier analysis was used in statistical comparisons between mortality and other parameters.

Results: The mean age of patients was 64±11.6. Patients with neuropathy were enrolled as group 1 (27.2%) and patients without neuropathy were enrolled as group 2 (72.8%). No significant association was found between age and peripheral neuropathy (p=1.00). The estimated median survival time was 27 months in patients with PN, whereas 56 months in patients without PN (p=0.273). In group 1 three year overall survival rate was 41% whereas in group 2 it was 57%.

Conclusion: It is important to understand pathophysiology of PN and recognize who is at risk since; it is a common side effect of MM treatment. This study is among the few analyses evaluating prevalence of peripheral neuropathy confirmed with electromyography in MM patients. There was no significant association between increased age, survival and neuropathy. Evaluating other associations and understanding potential risks with further research may guide us in developing better preventive and treatment modalities for PN in older MM patients