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Updated: Apr 12, 2026
Cell Subtype-specific Analysis of Neuronal Membrane Proteasome in Somatosensory Neurons
Published on: October 10, 2025
Bortezomib-associated demyelinating neuropathy--clinical and pathologic features
Sujata P Thawani1, Kurenai Tanji, Eduardo A De Sousa
1*Department of Neurology, Columbia Neuropathy Research Center, The Neurological Institute of New York, Columbia University Medical Center, New York, NY; †Division of Neuropathology, Department of Pathology and Cell Biology, Neuromuscular Pathology Laboratory, Columbia University College of Physicians and Surgeons, New York, NY; ‡Division of Neuromuscular Medicine, Department of Neurology, The University of Oklahoma Health Sciences Center, Oklahoma, OK.
Objectives:
Bortezomib is a proteasome inhibitor that is frequently used for multiple myeloma and lymphoma. A sensory predominant axonal neuropathy is associated with bortezomib treatment but a demyelinating neuropathy is also described primarily based on electrodiagnostic findings. We report a series of patients treated with bortezomib who developed peripheral neuropathy and were found to have demyelinating features on electrodiagnostic testing.
Methods:
Four patients who developed a bortezomib-induced peripheral neuropathy underwent electrophysiological testing, and 1 patient had a nerve biopsy.
Results:
The four patients with bortezomib-induced peripheral neuropathy had demyelinating features on their electrophysiological testing. The nerve biopsy performed in 1 patient demonstrated a demyelinating component in a background of axonal degeneration.
Conclusions:
Although most toxic neuropathies are symmetrical axonal neuropathies, bortezomib is part of a small list of agents that may cause a demyelinating polyneuropathy and axonal degeneration. These findings have been confirmed by nerve biopsy.
