neuropathy: constipation, abdo pain, urinary
retention, paralytic ileus. GI symptoms
especially when high-dose (>20mg).
neuropathy due to axonal degeneration
limbs especially; glove and stocking
Can be painful
burning, muscle cramps
is rare and late
early in onset of neuropathy as sensory
changes may not be reversible if therapy
affected. Usually painful axonal sensory distal
neuropathy. Tendon reflexes are
diminished, proprioception affected and a mild motor
neuropathy can occur.
factors are the cumulative dose of Velcade, route of
and pre-existing neuropathy.
show neuropathy is common with up to 22-50%
experiencing mild Grade 1 symptoms,
and 13-30% grade 2. More severe Grade 3 and 4 disease
in less common, occurring
in 7-15% of newly treated patients.
reduction was needed in 12% of patients due to
neuropathy, and 5% had to cease
therapy. Improvement usually occurs in around 3
months, but can take much
1: no change
1 with pain or Grade 2: reduce to 1.0mg/m2
2 with pain or Grade 3: Stop and restart when improved
4: Stop therapy
regimes now advocate weekly injections (rather than
twice a week).