Characteristics of pain syndrome, emotional disorders, and quality of life in patients with paraproteinemic polyneuropathy in multiple myeloma

Objective. To study characteristics of pain syndrome, emotional disorders, and quality of life indicators in patients with paraproteinemic polyneuropathy (PPPNP) in multiple myeloma (MM) before the start of chemotherapy courses.

Materials and methods. A total of 102 patients with multiple myeloma were examined prior to the initiation of chemotherapy courses. Based on symptoms assessment, neurological status, and the findings of stimulation electroneuromyography (EMG) of the upper and lower extremities, two patient subgroups were formed: with symptomatic paraproteinemic polyneuropathy and without it. The results of patient surveys were studied in each subgroup using questionnaires for diagnosing the intensity and nature of pain syndrome (VAS, DN4, CSI), live quality assessment (EORTC-QLQCIPN20, SF-36), and the presence of anxiety-depressive disorders (the Spielberger State-Trait Anxiety Inventory and the Beck Depression Inventory) followed by comparison of results between subgroups.

Results. Symptomatic paraproteinemic polyneuropathy was identified in 29 patients (28,4%; 95% CI (19,7-37,2)), whilst a significant correlation (p<0.05) was found between the severity of subjective and objective sensory and motor symptoms of paraproteinemic polyneuropathy and the quantitative parameters recorded of the EMG. In patients with symptomatic paraproteinemic polyneuropathy, the mental component of health and the average quality of life score were significantly lower (p<0.05), while the severity of the neuropathic and dysfunctional components of pain, as well as limb pain intensity, were significantly higher (p<0.05) compared to the remaining patients without the symptomatic form of paraproteinemic polyneuropathy.

Conclusion. Subject to the impact of symptomatic paraproteinemic polyneuropathy on the severity of neuropathic and dysfunctional pain components, as well as on the patients’ quality of life with multiple myeloma, its early clinical and instrumental diagnosis is essential with regard to a multidisciplinary approach to enhance the effectiveness of treatment for the underlying disease and its complications.

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