Review of peripheral neuropathy in plasma cell disorders

Peripheral neuropathy (PN) occurs frequently in patients with plasma cell disorders, a heterogeneous group of disorders resulting from the unregulated production of monoclonal proteins. This occurs both due to the dysproteinemia itself and as a consequence of the therapies used to treat the underlying plasma cell disorder. This comprehensive review of PN associated with plasma cell disorders will address both disease and therapy related PN, its pathogenesis and management with particular attention to multiple myeloma, monoclonal gammopathy of undetermined significance (MGUS), Waldenstrom's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) and amyloidosis. An understanding of this topic is critical for health care providers treating patients with plasma cell disorders due to the high frequency with which it occurs, the implications it has on selecting therapies for the underlying disorder and to best guide management of the neuropathy itself.