African American Race As a Risk Factor for Developing Peripheral Neuropathy in Newly Diagnosed Patients with Multiple Myeloma Receiving Bortezomib Induction

The incidence of multiple myeloma (MM) is two to three times higher in African Americans (AA) compared to other races, making it the most common hematological malignancy in this race. Current treatment guidelines recommend the combination of a proteasome inhibitor, immunomodulatory agent and a corticosteroid as a preferred induction therapy for both transplant and non-transplant candidates. Bortezomib is commonly used, and comes with the risk of peripheral neuropathy (PN) and potential need for dose reduction, therapy interruption, and additional supportive medications. Risk factors for bortezomib-induced peripheral neuropathy (BIPN) include diabetes mellitus (DM), prior therapy with thalidomide, advanced age and obesity. We identified a cohort of 748 newly diagnosed MM patients who received at least one full cycle of bortezomib as part of induction with bortezomib, lenalidomide, and dexamethasone (RVd) at the Winship Cancer Institute at Emory University from 2007-2016. One hundred and forty AA patients were matched with 140 non-AA patients on age, sex, body mass index (BMI), and route of bortezomib administration to control for confounding effects. By logistic regression model, the incidence of BIPN was higher in AA patients in both univariate (odds ratio, 1.61; 95% CI: 1.00-2.61; p=0.052) and multivariable analyses (odds ratio, 1.64; 95% CI 1.01-2.67; p=0.047). These data indicate that AA race is an independent risk factor for the development of BIPN.

Joseph:BMS: Research Funding; Janssen: Research Funding; GSK: Research Funding. Hofmeister:Sanofi: Research Funding; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Research Funding; GlaxoSmithKline: Membership on an entity's Board of Directors or advisory committees; Genzyme: Membership on an entity's Board of Directors or advisory committees; BlueBird Bio: Honoraria; Janssen: Membership on an entity's Board of Directors or advisory committees. Kaufman:AbbVie, Genentech, and Bristol Myers Squibb: Consultancy; AbbVie: Other: Member of steering committee; Incyte: Other: Member of data safety monitoring committee . Dhodapkar:Lava Therapeutics, Sanofi, Janssen: Membership on an entity's Board of Directors or advisory committees. Nooka:Bristol-Myers Squibb, Janssen, Takeda, Amgen, Adaptive, GlaxoSmithKline, Sanofi, Oncopeptides, Karyophram, SecureBio, and BeyondSprings: Consultancy, Honoraria. Lonial:Novartis, BMS, GSK, Amgen, Merck, Janssen: Honoraria; Celgene, Janssen, Takeda: Research Funding; AbbVie, Bluebird, Bristol-Myers Squibb, Celgene, GlaxoSmithKline, Janssen, Novartis Pharma, and Takeda.: Consultancy.