Prediction of bortezomib-induced peripheral neuropathy with the R–R interval variation of the electrocardiogram in plasma cell myeloma: a retrospective study

Abstract

Bortezomib-induced peripheral neuropathy (BIPN) is a key dose-limiting toxicity in patients with plasma cell myeloma (PCM). This study examined 56 patients with PCM treated with bortezomib to determine the possible predisposing factors to BIPN with the R–R interval variation (RRIV) of the electrocardiogram (ECG). Of all, 17 patients developed Clinically obvious BIPN, grades 2–4 or grade worsening from the baseline neuropathy per the National Cancer Institute's Common Terminology Criteria for Adverse Events (v5.0). In the receiver operating characteristic curve analysis, the optimal RRIV cutoff value to distinguish patients with and without risk to develop BIPN was 1.391. A lower RRIV before bortezomib treatment independently correlated with the onset of Clinically obvious BIPN (p = .002) and the time to the onset of Clinically obvious BIPN (p < 0.001). A lower RRIV of the ECG before the bortezomib treatment is a predictive factor for BIPN in PCM.

Keywords:

• Bortezomib-induced peripheral neuropathy
• plasma cell myeloma
• R–R interval variation
• electrocardiogram

Ethical approval and informed consent

The present study was conducted in accordance with the ethical standards of the Helsinki Declaration in 1975, after approval of the Ethics Committee of Osaka Medical College. The Ethics Committee of Osaka Medical College waive the requirement for the investigator to obtain a signed consent form for participants.

Disclosure statement

All authors declare that they have no conflict of interest.