A Pilot Study of Acupuncture in Treating Bortezomib-Induced Peripheral Neuropathy in Multiple Myeloma Patients

Abstract

Background: Peripheral neuropathy is the main dose limiting toxicity of bortezomib, an effective multiple myeloma (MM) therapy. Objectives: To examine the safety, feasibility and efficacy of acupuncture in reducing Bortezomib-Induced Peripheral Neuropathy (BIPN) symptoms. Methods: MM patients experiencing greater than or equal to grade 2 BIPN after discontinuation of bortezomib were included. Patients received acupuncture twice weekly for 2 weeks, then weekly for 4 weeks, and finally biweekly for 4 weeks. Clinical Total Neuropathy Score (TNSc), Functional Assessment of Cancer Therapy/ Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) questionnaire and Neuropathy Pain Scale (NPS) were used to assess patients' responses. Proinflammatory and neurotrophic cytokines at baseline, weeks 1, 2, 4, 8, 14 were measured in serum. Nerve conduction studies were performed at baseline and week 12. Results: Twenty-seven MM patients were enrolled in the trial, 26 (96%) were evaluable, 25 (93%) completed at least 4 acupuncture sessions, 20 (77%) completed all 10 sessions. There were no adverse events associated with the acupuncture treatment. At the end of the treatment, eighteen patients (69%) had > 30% reduction in NPS scores. NPS and FACT/GOG-Ntx scores improved significantly at week 10 and 14 when compared to baseline (p <0.001). The TNSc scores, an objective clinical assessment, did not significantly change. No significant changes were seen in serum cytokines. Of fifteen patients who had nerve conduction studies, five showed >10% increase in motor nerve amplitude. Limitations Single-arm, pilot study. Conclusions: Acupuncture is safe, feasible and induces subjective improvements in patients' symptoms. Further studies of Acupuncture are warranted.