Background and purposePeripheral neuropathy is a frequent complication of brentuximab vedotin (BV), used in CD30+ lymphoma treatment. Classic BV‐induced neuropathy (BV‐CN) is a mild distal sensory axonal polyneuropathy. Severe BV‐induced inflammatory neuropathies (BV‐IN) have been described. BV‐IN contribute to lymphoma‐associated morbidity but might be immunotherapy‐responsive. Our primary objective was to evaluate the rate of BV‐IN. Our secondary objectives were to determine risk factors and warning signs.MethodsWe conducted a retrospective cohort study on all patients treated with BV at our center between April 2014 and September 2021. Clinical, biological, and electrophysiological data were collected. BV‐induced neuropathy was defined as the occurrence of neuropathy up to 3 months after BV discontinuation. BV‐IN was defined with criteria adapted from European Academy of Neurology/Peripheral Nerve Society 2021 electrodiagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy. Other neuropathies were classified as BV‐CN.ResultsAmong 83 patients, 41 (49%) developed neuropathy: 35 BV‐CN and 6 BV‐IN. Thus, the rate of BV‐IN was 7.2%. Compared to patients with BV‐CN, no predisposing factor was identified. However, patients with BV‐IN more frequently presented muscle weakness (67% vs. 5.7%, p < 0.05), gait disorders (83% vs. 20%, p < 0.05), or acute or subacute onset (67% vs. 14%, p < 0.05). BV‐IN was frequently more severe (Common Terminology Criteria for Adverse Events grade ≥3; 50% vs. 0%, p < 0.05). Four patients were treated with immunotherapy.ConclusionsBrentuximab vedotin‐induced neuropathy is an overlooked complication. Based on four easily identifiable “red flags”, we provide an algorithm to help non‐neurologist physicians that care for BV‐treated patients to detect BV‐IN. The aim of the algorithm is to decrease the diagnostic and management delay of this disabling neuropathy.

中文翻译：

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与 brentuximab vedotin 治疗相关的炎症性神经病的发生率和特征

背景和目的周围神经病变是 brentuximab vedotin (BV) 的常见并发症，用于 CD30+ 淋巴瘤治疗。经典 BV 诱发的神经病 (BV-CN) 是一种轻度远端感觉轴突多发性神经病。严重 BV 诱发的炎症性神经病 (BV-IN) 已有描述。 BV-IN 会导致淋巴瘤相关发病率，但可能对免疫治疗有反应。我们的主要目标是评估 BV-IN 的发生率。我们的次要目标是确定危险因素和警告信号。方法我们对 2014 年 4 月至 2021 年 9 月期间在我们中心接受 BV 治疗的所有患者进行了回顾性队列研究。收集了临床、生物学和电生理学数据。 BV 诱发的神经病变定义为 BV 停药后 3 个月内发生的神经病变。 BV-IN 的定义采用欧洲神经病学学会/周围神经学会 2021 年慢性炎症性脱髓鞘性多发性神经根神经病电诊断标准改编的标准。其他神经病变被分类为 BV-CN。结果 在 83 名患者中，41 例 (49%) 出现神经病变：35 例 BV-CN 和 6 例 BV-IN。因此，BV-IN 的发生率为 7.2%。与 BV-CN 患者相比，未发现诱发因素。然而，BV-IN 患者更频繁地出现肌无力（67% vs. 5.7%，p< 0.05)，步态障碍（83% vs. 20%，p< 0.05)，或急性或亚急性发作（67% vs. 14%，p< 0.05）。 BV-IN 通常更严重（不良事件通用术语标准≥3 级；50% 与 0%，p< 0.05）。四名患者接受了免疫疗法。结论 Brentuximab vedotin 引起的神经病变是一种被忽视的并发症。基于四个易于识别的“危险信号”，我们提供了一种算法来帮助护理 BV 治疗患者的非神经科医生检测 BV-IN。该算法的目的是减少这种致残性神经病的诊断和治疗延迟。