Brentuximab-Induced Peripheral Neurotoxicity : A Multidisciplinary Approach to Manage an Emerging Challenge in Hodgkin Lymphoma Therapy
Velasco, Roser (Universitat Autònoma de Barcelona. Institut de Neurociències)
Domingo-Domenech, Eva (Universitat de Barcelona)
Sureda, Anna (Universitat de Barcelona)

Fecha:	2021
Resumen:	This article highlights the importance of monitoring peripheral neurotoxicity in patients with Hodgkin lymphoma (HL) who receive brentuximab vedotin, with a particular focus on early recognition and multidisciplinary management of this type of toxicity. Brentuximab vedotin-induced neurotoxicity (BVIN) is the most common non-haematological complication and cause of dose-delay or early discontinuation of BV treatment. An accurate and prompt diagnosis in patients with HL is essential to optimise management of this potentially disabling complication. Brentuximab vedotin (BV) is an anti-CD30 antibody-drug conjugate approved to treat classical Hodgkin lymphoma (HL). BV-induced peripheral neurotoxicity (BVIN) is one of the greatest concerns for haematologists treating HL for several reasons. First, BVIN is highly frequent. Most patients receiving BV will experience some degree of BVIN, resulting in the primary reason for dose modification or discontinuation of HL therapy. Second, BV produces sensory, motor, and/or autonomic peripheral nerve dysfunction, which can present as severe, disabling forms of BVIN-predominantly motor-in some patients. Third, although largely reversible, BVIN may persist months or years after treatment and thereby become a major issue in HL survivorship. BVIN may, therefore, negatively affect the quality of life and work-life of often young patients with HL, in whom long-term survival is expected. Currently, the only strategy for BVIN includes dose adjustments and treatment discontinuation; however, this could interfere with LH therapy efficacy. In this setting, early recognition and adequate management of BVIN are critical in improving clinical outcomes. Careful neurologic monitoring may allow accurate diagnoses and gradation of ongoing forms of BVIN presentation. This review analysed current, available data on epidemiology, pathophysiology, patient- and treatment-related risk factors, clinical and neurophysiologic phenotypes, and management in patients with HL. Furthermore, this review specifically addresses limitations posed by BVIN assessments in clinical practice and provides skills and tools to improve neurologic assessments in these patients. Integrating this neurotoxic drug in clinical practice requires a multidisciplinary approach to avoid or minimise neurotoxicity burden in survivors of HL.
Ayudas:	Instituto de Salud Carlos III PI20/00283
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Hodgkin lymphoma ; Brentuximab vedotin ; Neurotoxicity ; Peripheral neuropathy ; Chemotherapy-induced peripheral neuropathy ; Multidisciplinary
Publicado en:	Cancers, Vol. 13 (December 2021) , art. 6125, ISSN 2072-6694

DOI: 10.3390/cancers13236125
PMID: 34885234

24 p, 1.0 MB

El registro aparece en las colecciones:
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Neurociències (INc)
Artículos > Artículos de investigación
Artículos > Artículos publicados