Incidence, risk factors and management of osteonecrosis of the jaw in patients with multiple myeloma: a single-centre experience in 303 patients

Object of this study was to evaluate the efficacy of multiprofessional meetings in order to improve patients’ knowledge about cardiovascular diseases, risk factors and correct lifestyle in a Cardiovascular Rehabilitation Department. Methods: from November 2011 to June 2012 two MICRO-Q questionnaires were given to the Fossano Cardiovascular Rehabilitation’s patients before and after the educational meetings to test their improvement after having followed educational meetings. Results: 73 patients have answered the questionnaires (57 males, mean age 68,5 ±11.73ys). From these data emerged a significant improvement of knowledge about cardiovascular risk factors (75,34% vs 91,78%; p=0,01), smoke (79,45% vs 93,15%; p=0,03), stress (76,71% vs 91,78; p=0,023), diet (84,93% vs 97,26%; p=0,02), physical activity (63,01% vs 84,93%; p=0,005) and right things to do in case of chest pain (34,25% vs 52,05%; p=0,04). Conclusions: educational meetings had an important role in improve patients’ knowledge about cardiovascular risk factors, correct lifestyle and diet. Moreover MICRO-Q questionnaires demonstrated to be useful tools in order to improve the educational meetings according to the real needs of our patients.

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Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature

Blood ◽

10.1182/blood-2008-04-149385 ◽

2008 ◽

Vol 112 (5) ◽

pp. 1593-1599 ◽

Cited By ~ 259

Author(s):

Andreas A. Argyriou ◽

Gregoris Iconomou ◽

Haralabos P. Kalofonos

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Peripheral Neuropathy ◽

Treatment Plan ◽

Symptomatic Treatment ◽

Future Research ◽

Significant Activity ◽

Significant Toxicity ◽

Incidence Risk ◽

Schedule Change

AbstractBortezomib has demonstrated significant activity in clinical trials, mainly against recurrent or newly diagnosed multiple myeloma (MM). Peripheral neuropathy is a significant toxicity of bortezomib, requiring dose modification and potential changes in the treatment plan when it occurs. The mechanism underlying bortezomib-induced peripheral neuropathy (BIPN) is unknown. Metabolic changes resulting from the accumulation of bor-tezomib in the dorsal root ganglia cells, mitochondrial-mediated disregulation of Ca++ homeostasis, and disregulation of neurotrophins may contribute to the pathogenesis of BIPN. It is increasingly recognized that BIPN may be a proteasome inhibitor class effect, producing primarily a small fiber and painful, axonal, sensory distal neuropathy. Incidence of BIPN is mainly related to various risk factors, including cumulative dose and evidence of preexisting neuropathy. Assessment of BIPN is based primarily on neurologic clinical examination and neurophysiologic methods. To date, apart from the use of dose reduction and schedule change algorithm, there is no effective treatment with neuroprotective agents for BIPN. Analgesics, tricyclic antidepressants, anticonvulsants, and vitamin supplements have been used as symptomatic treatment against bortezomib-associated neuropathic pain with some success. This review looks critically at the pathogenesis, incidence, risk factors, diagnosis, characteristics, and management of BIPN, and highlights areas for future research.

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