How do you manage IgM related peripheral neuropathy?

Topics: Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • Neurology • Immune-mediated neuropathy • Mayo Clinic • NCI-CCC Myeloma Tumor Board Question • Mayo

Do you utilize rituximab or any other specific management strategies?

Answer from: Medical Oncologist at Community Practice

First things first, let's make sure it's IgM related. In patients with precursor disease (MGUS or smoldering) and neuropathy, I check B12, HbA1c, TSH, free T4, hepatitis B surface Ag, hepatitis B total core Ab, hepatitis C antibody, and cryoglobulins. In patients with specific risk factors, I check ...

Comments

Medical Oncologist at Mayo Clinic Rochester
Thanks for sharing your approach @Craig C. Hofmeis...

Medical Oncologist at Winship Cancer Institute of Emory University
I see this VERY rarely because I usually find the ...

Answer from: Medical Oncologist at Academic Institution

I see a number of these cases and I can tell you what I have learned through experience. When the underlying process is LPL/waldenstrom’s, single agent Rituximab for 4 weekly doses can be highly effective. I give it six months to see improvement. I track IgM and not the MAG antibodies for imp...

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