Abstract
The association between clonal haematological disorders and peripheral nerve disease is recognized. Paraproteinaemic phenomena are the most common mechanism, but direct neural lymphomatous infiltration is seen and can be challenging to diagnose. Traditional and novel anticancer therapies have neuropathic side effects. Novel studies using sensitive techniques are refining the incidence of peripheral neuropathy in patients with a monoclonal gammopathy, and the pathogenesis of IgM Peripheral neuropathy (PN) and POEMS syndrome. Recent series give insight into the characteristics and diagnostic challenges of patients with neurolymphomatosis and amyloid light chain amyloidosis. There is an increasing repertoire of effective anticancer drugs in haematological oncology, but chemotherapy-related neuropathy remains a common side effect. This review of the current literature focuses on recent updates and developments for the paraproteinaemic neuropathies, and the evaluation, diagnosis and treatment of peripheral nerve disease due to high-grade and low-grade lymphomas and lymphoproliferative disorders.
Overview
- The study focuses on the association between clonal haematological disorders and peripheral nerve disease, specifically paraproteinaemic phenomena and direct neural lymphomatous infiltration. The methodology used includes traditional and novel anticancer therapies, sensitive techniques to refine the incidence of peripheral neuropathy in patients with a monoclonal gammopathy, and the pathogenesis of IgM Peripheral neuropathy (PN) and POEMS syndrome. The primary objective is to provide an update and evaluation of the current literature on paraproteinaemic neuropathies and the diagnosis and treatment of peripheral nerve disease due to high-grade and low-grade lymphomas and lymphoproliferative disorders.
Comparative Analysis & Findings
- The study compares the outcomes observed under different experimental conditions or interventions, specifically traditional and novel anticancer therapies. The results show that chemotherapy-related neuropathy remains a common side effect, despite an increasing repertoire of effective anticancer drugs in haematological oncology. The study identifies direct neural lymphomatous infiltration as a challenging diagnosis, and highlights the importance of sensitive techniques to refine the incidence of peripheral neuropathy in patients with a monoclonal gammopathy. The pathogenesis of IgM Peripheral neuropathy (PN) and POEMS syndrome is also discussed, providing insight into the characteristics and diagnostic challenges of patients with neurolymphomatosis and amyloid light chain amyloidosis.
Implications and Future Directions
- The study's findings have significant implications for the field of research and clinical practice, as they highlight the importance of sensitive techniques to diagnose and treat peripheral nerve disease due to clonal haematological disorders. The study also identifies chemotherapy-related neuropathy as a common side effect, which highlights the need for further research to develop effective treatments for this condition. Future research directions could include the development of novel anticancer therapies with reduced neuropathic side effects, as well as the exploration of the role of genetic and epigenetic factors in the development of peripheral neuropathy in clonal haematological disorders.