Peripheral Neuropathy and Hypovitaminosis D Are Associated in Multiple Myeloma Patients

Abstract

Introduction New strategies in the treatment of multiple myeloma (MM) have improved response rates, progression-free survival and overall survival (OS). Despite the advances in treatment, patients frequently experience adverse events such as chemotherapy-induced peripheral neuropathy (CIPN). CIPN decreases quality of life, and requires dose adjustment, delay or premature termination of treatment, resulting in a negative influence on time to progression and survival. In addition, several studies have found that up to 54% of MM patients have peripheral neuropathy (PN) at diagnosis. A possible mechanism of vitamin D deficiency and PN was found in animal trials, where an increase of nerve growth factor was observed in diabetic rats after supplementation of vitamin D. Furthermore, correction of hypovitaminosis D through vitamin D supplementation was found to reduce PN in patients with DM type 2. Objectives S The primary objective of this study was to determine the correlation between the 25-hydroxyvitamin D serum levels and PN in patients with smoldering or symptomatic MM. Secondary objectives were to gain insight into the number of patients with inadequate 25-hydroxyvitamin D serum levels ( 75 nmol/L were diagnosed with MM for a shorter period of time, and received more intensive treatment. A trend was found between lower vitamin D levels (grouped 75 nmol/L) and higher incidence of PN (p = 0.036). Conclusions PN and hypovitaminosis D are common in MM patients, and low vitamin D levels are possibly associated with the occurrence of PN. In addition, more attention for PN is needed, as PN is underreported by clinicians. Further research is necessary to clarify the relationship between vitamin D and PN, and whether vitamin D supplementation could positively influence PN in MM patients.