다발성 골수종 환자에서 Lenalidomide와 Thalidomide에 의한 말초신경병증 발병 비교 연구

Comparative Analysis of Lenalidomide versus Thalidomide in Multiple Myeloma; Drug-Induced Peripheral Neuropathy

Lenalidomide (LD) inhibits angiogenesis and exerts immunosuppressive effects. It has been used to treatmultiple myeloma and is known to show positive differences in side effects compared to thalidomide (TD). Peripheralneuropathy, one of the most common complications of TD, has been reported to be less frequent with LD treatment. However, no local study has been conducted to compare the incidence of peripheral neuropathy associated with TD andLD administration. Therefore, this study was performed to investigate the appearance, aggravation, or improvement ofperipheral neuropathy and the relevant risk factors in patients treated with LD and TD. The electronic medical records of169 patients with multiple myeloma who had been treated with LD and TD in a tertiary hospital between March 2014and March 2015 were retrospectively reviewed. There were 85 patients in the LD group and 84 patients in the TD groupfor the final analysis. An increase in severity of peripheral neuropathy after treatment was observed in 2.4% and 19.1%of patients in the LD and TD groups, respectively (p<0.001). Six patients in the TD group showed two or more increasesin grade. In total, 48.2% in the LD group and 10.7% in the TD group (p<0.001) continued chemotherapy without anyaggravation of peripheral neuropathy. The patients treated with LD showed less increase in severity of peripheralneuropathy compared with those treated with TD. A significant difference was observed between the groups in thepercentage of patients who continued treatment without peripheral neuropathy aggravation.