Skip to main content
SpringerLink
Log in

Neurologic Complications of Myeloma

  • Chapter
  • First Online:
Book cover Multiple Myeloma

Abstract

Patients with multiple myeloma frequently develop neurological complications related to the disease or its treatment [1–3]. These neurological complications may affect the central nervous system (CNS) [4] or more commonly the peripheral nervous system (PNS) [1, 5]. Neurological complications can result from:

  1. (a)

    Direct infiltration of the nervous system by neoplastic cells [4]

  2. (b)

    Indirect effect such as paraneoplastic syndrome or amyloid deposition [5]

  3. (c)

    Iatrogenic effect during multiple myeloma treatment [1]

  4. (d)

    Toxic-metabolic syndrome related to systemic complications of multiple myeloma [6]

  5. (e)

    A combination of the above

Furthermore, a neurological syndrome can be the presenting sign of multiple myeloma [7]. In this chapter we will discuss this different neurological complication of myeloma by system (CNS vs. PNS) and the management of these complications (Table 20.1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Plasmati R, Pastorelli F, Cavo M, Petracci E, Zamagni E, Tosi P, et al. Neuropathy in multiple myeloma treated with thalidomide: a prospective study. Neurology. 2007;69(6):573–81.

    Article  PubMed  CAS  Google Scholar 

  2. Richardson PG, Xie W, Mitsiades C, Chanan-Khan AA, Lonial S, Hassoun H, et al. Single-agent bortezomib in previously untreated multiple myeloma: efficacy, characterization of peripheral neuropathy, and molecular correlations with response and neuropathy. J Clin Oncol. 2009;27(21):3518–25.

    Article  PubMed  CAS  Google Scholar 

  3. Dispenzieri A, Kyle RA. Neurological aspects of multiple myeloma and related disorders. Best Pract Res Clin Haematol. 2005;18(4):673–88.

    Article  PubMed  CAS  Google Scholar 

  4. Fassas AB, Ward S, Muwalla F, Van Hemert R, Schluterman K, Harik S, et al. Myeloma of the central nervous system: strong association with unfavorable chromosomal abnormalities and other high-risk disease features. Leuk Lymphoma. 2004;45(2):291–300.

    Article  PubMed  Google Scholar 

  5. Smestad C, Monstad P, Lindboe CF, Mygland A. Amyloid myopathy presenting with distal atrophic weakness. Muscle Nerve. 2004;29(4):605–9.

    Article  PubMed  Google Scholar 

  6. Camacho J, Arnalich F, Anciones B, Pena JM, Gil A, Barbado FJ, et al. The spectrum of neurological manifestations in myeloma. J Med. 1985;16(5–6):597–611.

    PubMed  CAS  Google Scholar 

  7. Hogan MC, Lee A, Solberg LA, Thome SD. Unusual presentation of multiple myeloma with unilateral visual loss and numb chin syndrome in a young adult. Am J Hematol. 2002;70(1):55–9.

    Article  PubMed  Google Scholar 

  8. Matsuzaki H, Hata H, Sonoki T, Matsuno F, Kuribayashi N, Yoshida M, et al. Serum amino acid disturbance in multiple myeloma with hyperammonemia. Int J Hematol. 1995;61(3):131–7.

    Article  PubMed  CAS  Google Scholar 

  9. Talamo G, Cavallo F, Zangari M, Barlogie B, Lee CK, Pineda-Roman M, et al. Hyperammonemia and encephalopathy in patients with multiple myeloma. Am J Hematol. 2007;82(5):414–5.

    Article  PubMed  Google Scholar 

  10. Otsuki T, Yamada O, Sakaguchi H, Ichiki T, Kouguchi K, Wada H, et al. In vitro excess ammonia production in human myeloma cell lines. Leukemia. 1998;12(7): 1149–58.

    Article  PubMed  CAS  Google Scholar 

  11. Kwan L, Wang C, Levitt L. Hyperammonemic encephalopathy in multiple myeloma. N Engl J Med. 2002;346(21):1674–5.

    Article  PubMed  Google Scholar 

  12. Swash M, Rowan AJ. Electroencephalographic criteria of hypocalcemia and hypercalcemia. Arch Neurol. 1972;26(3):218–28.

    Article  PubMed  CAS  Google Scholar 

  13. Lourbopoulos A, Ioannidis P, Balogiannis I, Stavrinou P, Koletsa T, Karacostas D. Cervical epidural plasmacytoma presenting as ascending paraparesis. Spine J. 2011;11(5):e1–4.

    Article  PubMed  Google Scholar 

  14. Okacha N, Chrif E, Brahim E, Ali A, Abderrahman E, Gazzaz M, et al. Extraosseous epidural multiple myeloma presenting with thoracic spine compression. Joint Bone Spine. 2008;75(1):70–2.

    Article  PubMed  Google Scholar 

  15. Zeng Z, Zheng L, Lin J, Chen J. Successful bortezomib treatment in combination with dexamethasone and thalidomide for previously untreated epidural plasmacytoma. Oncol Lett. 2012;3(3):557–9.

    PubMed  CAS  Google Scholar 

  16. Svien HJ, Price RD, Bayrd ED. Neurosurgical treatment of compression of the spinal cord caused by myeloma. J Am Med Assoc. 1953;153(9):784–6.

    Article  PubMed  CAS  Google Scholar 

  17. Lupu VD, Saini N, Balish M. CNS myelomatosis. Neurology. 2005;64(6):1007.

    Article  PubMed  Google Scholar 

  18. Yaman E, Benekli M, Coskun U, Sezer K, Ozturk B, Kaya AO, et al. Intrasellar plasmacytoma: an unusual presentation of multiple myeloma. Acta Neurochir. 2008;150(9):921–4; discussion 4.

    Article  PubMed  CAS  Google Scholar 

  19. Sheng B, Mak VW, Lee HK, Li HL, Lee IP, Wong S. Multiple myeloma presenting with acute disseminated encephalomyelitis: causal or chance link? Neurology. 2006;67(10):1893–4.

    Article  PubMed  CAS  Google Scholar 

  20. Vokaer M, de Zegers Beyl D, Bier JC. Multiple myeloma presenting with acute disseminated encephalomyelitis: causal or chance link? Neurology. 2007;68(21):1873–4; author reply 4.

    Article  PubMed  Google Scholar 

  21. Clow EC, Couban S, Grant IA. Stiff-person syndrome associated with multiple myeloma following autologous bone marrow transplantation. Muscle Nerve. 2008;38(6):1649–52.

    Article  PubMed  Google Scholar 

  22. Schiff D, Dalmau J, Myers DJ. Anti-GAD antibody positive stiff-limb syndrome in multiple myeloma. J Neurooncol. 2003;65(2):173–5.

    Article  PubMed  Google Scholar 

  23. Adams BD, Baker R, Lopez JA, Spencer S. Myeloproliferative disorders and the hyperviscosity syndrome. Emerg Med Clin North Am. 2009;27(3) :459–76.

    Article  PubMed  Google Scholar 

  24. Mehta J, Singhal S. Hyperviscosity syndrome in plasma cell dyscrasias. Semin Thromb Hemost. 2003;29(5):467–71.

    Article  PubMed  Google Scholar 

  25. Gupta A, Pandey A, Sethi S. Bortezomib-induced congestive cardiac failure in a patient with multiple myeloma. Cardiovasc Toxicol. 2012;12(2):184–7.

    Article  PubMed  Google Scholar 

  26. Kelly Jr JJ, Kyle RA, Miles JM, O’Brien PC, Dyck PJ. The spectrum of peripheral neuropathy in myeloma. Neurology. 1981;31(1):24–31.

    Article  PubMed  Google Scholar 

  27. Walsh JC. The neuropathy of multiple myeloma. An electrophysiological and histological study. Arch Neurol. 1971;25(5):404–14.

    Article  PubMed  CAS  Google Scholar 

  28. Malhotra P, Choudhary PP, Lal V, Varma N, Suri V, Varma S. Prevalence of peripheral neuropathy in multiple myeloma at initial diagnosis. Leuk Lymphoma. 2011;52(11):2135–8.

    Article  PubMed  Google Scholar 

  29. Stork AC, van der Pol WL, van Kessel D, Lokhorst HM, Notermans NC. Effect of stem cell transplantation for B-cell malignancies on disease course of associated polyneuropathy. J Neurol. 2012;259(10): 2100–4.

    Article  PubMed  CAS  Google Scholar 

  30. Ansari-Lari MA, Ali SZ. Fine-needle aspiration of abdominal fat pad for amyloid detection: a clinically useful test? Diagn Cytopathol. 2004;30(3):178–81.

    Article  PubMed  Google Scholar 

  31. Murakami T, Tachibana S, Endo Y, Kawai R, Hara M, Tanase S, et al. Familial carpal tunnel syndrome due to amyloidogenic transthyretin His 114 variant. Neurology. 1994;44(2):315–8.

    Article  PubMed  CAS  Google Scholar 

  32. Jagannath S, Durie BG, Wolf JL, Camacho ES, Irwin D, Lutzky J, et al. Extended follow-up of a phase 2 trial of bortezomib alone and in combination with dexamethasone for the frontline treatment of multiple myeloma. Br J Haematol. 2009;146(6):619–26.

    Article  PubMed  CAS  Google Scholar 

  33. Cavaletti G, Gilardini A, Canta A, Rigamonti L, Rodriguez-Menendez V, Ceresa C, et al. Bortezomib-induced peripheral neurotoxicity: a neurophysiological and pathological study in the rat. Exp Neurol. 2007;204(1):317–25.

    Article  PubMed  CAS  Google Scholar 

  34. Richardson PG, Delforge M, Beksac M, Wen P, Jongen JL, Sezer O, et al. Management of treatment-emergent peripheral neuropathy in multiple myeloma. Leukemia. 2012;26(4):595–608.

    Article  PubMed  CAS  Google Scholar 

  35. Jagannath S, Barlogie B, Berenson J, Siegel D, Irwin D, Richardson PG, et al. A phase 2 study of two doses of bortezomib in relapsed or refractory myeloma. Br J Haematol. 2004;127(2):165–72.

    Article  PubMed  CAS  Google Scholar 

  36. Richardson PG, Barlogie B, Berenson J, Singhal S, Jagannath S, Irwin D, et al. A phase 2 study of bortezomib in relapsed, refractory myeloma. N Engl J Med. 2003;348(26):2609–17.

    Article  PubMed  CAS  Google Scholar 

  37. Richardson PG, Sonneveld P, Schuster MW, Irwin D, Stadtmauer EA, Facon T, et al. Bortezomib or high-dose dexamethasone for relapsed multiple myeloma. N Engl J Med. 2005;352(24):2487–98.

    Article  PubMed  CAS  Google Scholar 

  38. San Miguel JF, Schlag R, Khuageva NK, Dimopoulos MA, Shpilberg O, Kropff M, et al. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med. 2008;359(9):906–17.

    Article  PubMed  CAS  Google Scholar 

  39. Richardson PG, Briemberg H, Jagannath S, Wen PY, Barlogie B, Berenson J, et al. Frequency, characteristics, and reversibility of peripheral neuropathy during treatment of advanced multiple myeloma with bortezomib. J Clin Oncol. 2006;24(19):3113–20.

    Article  PubMed  CAS  Google Scholar 

  40. Richardson PG, Sonneveld P, Schuster MW, Stadtmauer EA, Facon T, Harousseau JL, et al. Reversibility of symptomatic peripheral neuropathy with bortezomib in the phase III APEX trial in relapsed multiple myeloma: impact of a dose-modification guideline. Br J Haematol. 2009;144(6):895–903.

    Article  PubMed  CAS  Google Scholar 

  41. Mateos MV, Oriol A, Martinez-Lopez J, Gutierrez N, Teruel AI, de Paz R, et al. Bortezomib, melphalan, and prednisone versus bortezomib, thalidomide, and prednisone as induction therapy followed by maintenance treatment with bortezomib and thalidomide versus bortezomib and prednisone in elderly patients with untreated multiple myeloma: a randomised trial. Lancet Oncol. 2010;11(10):934–41.

    Article  PubMed  CAS  Google Scholar 

  42. Moreau P, Pylypenko H, Grosicki S, Karamanesht I, Leleu X, Grishunina M, et al. Subcutaneous versus intravenous administration of bortezomib in patients with relapsed multiple myeloma: a randomised, phase 3, non-inferiority study. Lancet Oncol. 2011;12(5):431–40.

    Article  PubMed  Google Scholar 

  43. Argyriou AA, Iconomou G, Kalofonos HP. Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature. Blood. 2008;112(5):1593–9.

    Article  PubMed  CAS  Google Scholar 

  44. Cata JP, Weng HR, Burton AW, Villareal H, Giralt S, Dougherty PM. Quantitative sensory findings in patients with bortezomib-induced pain. J Pain. 2007;8(4):296–306.

    Article  PubMed  CAS  Google Scholar 

  45. Saifee TA, Elliott KJ, Lunn MP, Blake J, Reilly MM, Rabin N, et al. Bortezomib-induced inflammatory neuropathy. J Peripher Nerv Syst. 2010;15(4):366–8.

    Article  PubMed  Google Scholar 

  46. Ravaglia S, Corso A, Piccolo G, Lozza A, Alfonsi E, Mangiacavalli S, et al. Immune-mediated neuropathies in myeloma patients treated with bortezomib. Clin Neurophysiol. 2008;119(11):2507–12.

    Article  PubMed  CAS  Google Scholar 

  47. Mauermann ML, Blumenreich MS, Dispenzieri A, Staff NP. A case of peripheral nerve microvasculitis associated with multiple myeloma and bortezomib treatment. Muscle Nerve. 2012;46(6):970–7.

    Article  PubMed  Google Scholar 

  48. Chanan-Khan AA, Lonial S, Weber D, Borrello I, Foa R, Hellmann A, et al. Lenalidomide in combination with dexamethasone improves survival and time-to-progression in patients ≥65 years old with relapsed or refractory multiple myeloma. Int J Hematol. 2012; 96(2):254–62.

    Article  PubMed  CAS  Google Scholar 

  49. Kroger N, Zabelina T, Klyuchnikov E, Kropff M, Pfluger KH, Burchert A, et al. Toxicity-reduced, myeloablative allograft followed by lenalidomide maintenance as salvage therapy for refractory/relapsed myeloma patients. Bone Marrow Transplant. 2012; 48(3):403–7.

    Article  PubMed  Google Scholar 

  50. Jakubowiak AJ, Dytfeld D, Griffith KA, Lebovic D, Vesole DH, Jagannath S, et al. A phase 1/2 study of carfilzomib in combination with lenalidomide and low-dose dexamethasone as a frontline treatment for multiple myeloma. Blood. 2012;120(9):1801–9.

    Article  PubMed  CAS  Google Scholar 

  51. Berenson JR, Yellin O, Kazamel T, Hilger JD, Chen CS, Cartmell A, et al. A phase 2 study of pegylated liposomal doxorubicin, bortezomib, dexamethasone and lenalidomide for patients with relapsed/refractory multiple myeloma. Leukemia. 2012;26(7):1675–80.

    Article  PubMed  CAS  Google Scholar 

  52. Bastuji-Garin S, Ochonisky S, Bouche P, Gherardi RK, Duguet C, Djerradine Z, et al. Incidence and risk factors for thalidomide neuropathy: a prospective study of 135 dermatologic patients. J Invest Dermatol. 2002;119(5):1020–6.

    Article  PubMed  CAS  Google Scholar 

  53. Rajkumar SV, Hayman S, Gertz MA, Dispenzieri A, Lacy MQ, Greipp PR, et al. Combination therapy with thalidomide plus dexamethasone for newly diagnosed myeloma. J Clin Oncol. 2002;20(21):4319–23.

    Article  PubMed  CAS  Google Scholar 

  54. Rajkumar SV, Dispenzieri A, Fonseca R, Lacy MQ, Geyer S, Lust JA, et al. Thalidomide for previously untreated indolent or smoldering multiple myeloma. Leukemia. 2001;15(8):1274–6.

    Article  PubMed  CAS  Google Scholar 

  55. Chaudhry V, Cornblath DR, Corse A, Freimer M, Simmons-O’Brien E, Vogelsang G. Thalidomide-induced neuropathy. Neurology. 2002;59(12):1872–5.

    Article  PubMed  CAS  Google Scholar 

  56. Fullerton PM, Kremer M. Neuropathy after intake of thalidomide (distaval). Br Med J. 1961;2(5256): 855–8.

    Article  PubMed  CAS  Google Scholar 

  57. Lagueny A, Rommel A, Vignolly B, Taieb A, Vendeaud-Busquet M, Doutre MS, et al. Thalidomide neuropathy: an electrophysiologic study. Muscle Nerve. 1986;9(9):837–44.

    Article  PubMed  CAS  Google Scholar 

  58. Molloy FM, Floeter MK, Syed NA, Sandbrink F, Culcea E, Steinberg SM, et al. Thalidomide neuropathy in patients treated for metastatic prostate cancer. Muscle Nerve. 2001;24(8):1050–7.

    Article  PubMed  CAS  Google Scholar 

  59. Giannini F, Volpi N, Rossi S, Passero S, Fimiani M, Cerase A. Thalidomide-induced neuropathy: a ganglionopathy? Neurology. 2003;60(5):877–8.

    Article  PubMed  CAS  Google Scholar 

  60. Mileshkin L, Stark R, Day B, Seymour JF, Zeldis JB, Prince HM. Development of neuropathy in patients with myeloma treated with thalidomide: patterns of occurrence and the role of electrophysiologic monitoring. J Clin Oncol. 2006;24(27):4507–14.

    Article  PubMed  CAS  Google Scholar 

  61. Richardson P, Schlossman R, Jagannath S, Alsina M, Desikan R, Blood E, et al. Thalidomide for patients with relapsed multiple myeloma after high-dose chemotherapy and stem cell transplantation: results of an open-label multicenter phase 2 study of efficacy, toxicity, and biological activity. Mayo Clin Proc. 2004;79(7):875–82.

    Article  PubMed  CAS  Google Scholar 

  62. Johnson DC, Corthals SL, Walker BA, Ross FM, Gregory WM, Dickens NJ, et al. Genetic factors underlying the risk of thalidomide-related neuropathy in patients with multiple myeloma. J Clin Oncol. 2011;29(7):797–804.

    Article  PubMed  CAS  Google Scholar 

  63. Harousseau JL, Attal M, Avet-Loiseau H, Marit G, Caillot D, Mohty M, et al. Bortezomib plus dexamethasone is superior to vincristine plus doxorubicin plus dexamethasone as induction treatment prior to autologous stem-cell transplantation in newly diagnosed multiple myeloma: results of the IFM 2005–01 phase III trial. J Clin Oncol. 2010; 28(30):4621–9.

    Article  PubMed  CAS  Google Scholar 

  64. Dimopoulos MA, Pouli A, Zervas K, Grigoraki V, Symeonidis A, Repoussis P, et al. Prospective randomized comparison of vincristine, doxorubicin and dexamethasone (VAD) administered as intravenous bolus injection and VAD with liposomal doxorubicin as first-line treatment in multiple myeloma. Ann Oncol. 2003;14(7):1039–44.

    Article  PubMed  CAS  Google Scholar 

  65. Sonneveld P, Suciu S, Weijermans P, Beksac M, Neuwirtova R, Solbu G, et al. Cyclosporin A combined with vincristine, doxorubicin and dexamethasone (VAD) compared with VAD alone in patients with advanced refractory multiple myeloma: an EORTC-HOVON randomized phase III study (06914). Br J Haematol. 2001;115(4):895–902.

    Article  PubMed  CAS  Google Scholar 

  66. Oken MM, Harrington DP, Abramson N, Kyle RA, Knospe W, Glick JH. Comparison of melphalan and prednisone with vincristine, carmustine, melphalan, cyclophosphamide, and prednisone in the treatment of multiple myeloma: results of Eastern Cooperative Oncology Group Study E2479. Cancer. 1997;79(8): 1561–7.

    Article  PubMed  CAS  Google Scholar 

  67. Pal PK. Clinical and electrophysiological studies in vincristine induced neuropathy. Electromyogr Clin Neurophysiol. 1999;39(6):323–30.

    PubMed  CAS  Google Scholar 

  68. Casey EB, Jellife AM, Le Quesne PM, Millett YL. Vincristine neuropathy. Clinical and electrophysiological observations. Brain. 1973;96(1):69–86.

    Article  PubMed  CAS  Google Scholar 

  69. McLeod JG, Penny R. Vincristine neuropathy: an electrophysiological and histological study. J Neurol Neurosurg Psychiatry. 1969;32(4):297–304.

    Article  PubMed  CAS  Google Scholar 

  70. Nasu S, Misawa S, Sekiguchi Y, Shibuya K, Kanai K, Fujimaki Y, et al. Different neurological and physiological profiles in POEMS syndrome and chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry. 2012;83(5):476–9.

    Article  PubMed  Google Scholar 

  71. Mauermann ML, Sorenson EJ, Dispenzieri A, Mandrekar J, Suarez GA, Dyck PJ. Uniform demyelination and more severe axonal loss distinguish POEMS syndrome from CIDP. J Neurol Neurosurg Psychiatry. 2012;83(5):480–6.

    Article  PubMed  Google Scholar 

  72. Kanai K, Sawai S, Sogawa K, Mori M, Misawa S, Shibuya K, et al. Markedly upregulated serum interleukin-12 as a novel biomarker in POEMS syndrome. Neurology. 2012;79(6):575–82.

    Article  PubMed  CAS  Google Scholar 

  73. D’Souza A, Hayman SR, Buadi F, Mauermann M, Lacy MQ, Gertz MA, et al. The utility of plasma vascular endothelial growth factor levels in the diagnosis and follow-up of patients with POEMS syndrome. Blood. 2011;118(17):4663–5.

    Article  PubMed  Google Scholar 

  74. Skinner M, Sanchorawala V, Seldin DC, Dember LM, Falk RH, Berk JL, et al. High-dose melphalan and autologous stem-cell transplantation in patients with AL amyloidosis: an 8-year study. Ann Intern Med. 2004;140(2):85–93.

    Article  PubMed  CAS  Google Scholar 

  75. Brenner B, Carter A, Freidin N, Malberger E, Tatarsky I. Pancoast’s syndrome in multiple myeloma. Acta Haematol. 1984;71(5):353–5.

    Article  PubMed  CAS  Google Scholar 

  76. Prayson RA. Amyloid myopathy: clinicopathologic study of 16 cases. Hum Pathol. 1998;29(5):463–8.

    Article  PubMed  CAS  Google Scholar 

  77. Lawson TM, Bevan MA, Williams BD. Clinical images: skeletal muscle pseudo-hypertrophy in myeloma-associated amyloidosis. Arthritis Rheum. 2002;46(8):2251.

    Article  PubMed  Google Scholar 

  78. Cibeira MT, Mercadal S, Arenillas L, Muntanola A, Salamero O, Blade J. Bortezomib-induced rhabdomyolysis in multiple myeloma. Acta Haematol. 2006;116(3):203–6.

    Article  PubMed  Google Scholar 

  79. Perrot S, Le Jeunne C. Steroid-induced myopathy. Presse Med. 2012;41(4):422–6.

    Article  PubMed  Google Scholar 

  80. Kalambokis G, Theodorou A, Kosta P, Tsianos EV. Multiple myeloma presenting with pyomyositis caused by community-acquired methicillin-resistant Staphylococcus aureus: report of a case and literature review. Int J Hematol. 2008;87(5):516–9.

    Article  PubMed  Google Scholar 

  81. Dimopoulos MA, Mateos MV, Richardson PG, Schlag R, Khuageva NK, Shpilberg O et al. Risk factors for, and reversibility of, peripheral neuropathy associated with bortezomib-melphalan-prednisone in newly diagnosed patients with multiple myeloma: subanalysis of the phase 3 VISTA study. Eur J Haematol. 2011;86:23–31.

    Google Scholar 

  82. Bringhen S, Larocca A, Rossi D, Cavalli M, Genuardi M, Ria R et al. Efficacy and safety of once weekly bortezomib in multiple myeloma patients. Blood 2010;116:4745–4753.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA

    Chafic Y. Karam M.D. & Michelle L. Mauermann M.D.

Authors
  1. Chafic Y. Karam M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michelle L. Mauermann M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michelle L. Mauermann M.D. .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Department of Internal Medicine Division of Hematology, Rochester, Minnesota, USA

    Morie A. Gertz

  2. Mayo Clinic, Myeloma Amyloidosis Dysproteinemia Group Division of Hematology, Rochester, Minnesota, USA

    S. Vincent Rajkumar

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Mayo Foundation for Medical Education and Research

About this chapter

Cite this chapter

Karam, C.Y., Mauermann, M.L. (2014). Neurologic Complications of Myeloma. In: Gertz, M., Rajkumar, S. (eds) Multiple Myeloma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8520-9_20

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8520-9_20

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8519-3

  • Online ISBN: 978-1-4614-8520-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation