Effect Of Bortezomib-based Chemotherapy On Cognition And Emotion In Patients With Multiple Myeloma

objective: Chemotherapy can cause short-term or long-term neurological dysfunction in some patients,such as cognitive dysfunction and emotional changes,which are manifested as decreased attention and memory,retardation of thinking,decreased executive ability and anxiety inhibition.The objective of this study was to investigate the effects of bortezomib based chemotherapy on cognitive function and mood in patients with multiple myeloma.Methods: A total of 130 patients with multiple myeloma admitted to the Affiliated Hospital of Anhui Medical University from November 2020 to July 2021 were enrolled as the study subjects.According to whether bortezomib was used for bortezomib exposure,they were divided into non-bortezomib exposure group（31 cases）and bortezomib exposure group（99 cases）.The bortezomib exposure group was divided into bortezomib exposure ≤4 courses（58 cases）and bortezomib exposure > 4 courses（41 cases）according to the treatment course of bortezomib exposure.The Montreal Scale（Mo CA）score,Hamilton Anxiety Scale（HAMA）score,Hamilton Depression Scale（HAMD）score and serum tumor necrosis factor-A（TNF-A）levels in each group were compared,and the correlation between TNF-A and cognitive function,mood（anxiety and depression）in bortezomib exposure group was analyzed.Results:Mo CA,HAMA and HAMD scores in bortezomib exposure group were lower than those in non-bortezomib exposure group,and serum TNF-A level was higher than that in non-bortezomib exposure group,the differences were statistically significant（P < 0.05）.Mo CA score of bortezomib exposure ≤4 treatment courses group was higher than that of bortezomib exposure >4 treatment courses group,and serum TNF-A level was lower than that of bortezomib exposure >4 treatment courses group,the differences were statistically significant（P < 0.05）.There was no significant difference in HAMA and HAMD scores between the two groups（P >0.05）.Correlation analysis showed that TNF-A was negatively correlated with Mo CA score in bortezomib exposure group（P < 0.05）,but not with anxiety（HAMA）and depression（HAMD）（P > 0.05）.Conclusion : Bortezomib based chemotherapy may affect cognitive function but not mood in patients with multiple myeloma;With the prolongation of chemotherapy cycle,cognitive function decreased more significantly.Cognitive decline in patients with multiple myeloma treated with bortezomib based chemotherapy was inversely associated with serum TNF-a levels.