Expert consensus on the management of peripheral neuropathy in patients with lymphoma on brentuximab vedotin

Abstract Purpose Brentuximab vedotin (BV) represents a therapeutic advancement in the treatment of CD30-positive lymphomas, yet its clinical utility is often limited by BV-induced peripheral neuropathy (PN). Currently, evidence-based, BV-specific guidelines for the assessment and management of PN are scarce, resulting in variability in clinical practice. This study aimed to establish international expert consensus on the optimal assessment, monitoring and management strategies for BV-induced PN in patients with lymphoma. Methods A modified Delphi panel was conducted, engaging a total of 13 experts from eight different countries and representing haematology, neurology, dermatology, nursing and allied health disciplines. Panellists participated in three rounds of structured surveys, with statements developed based on a targeted literature review and guidance from an expert steering committee. Consensus was defined as ≥ 70% agreement/disagreement. Consensus was achieved on 60/87 (69%) statements across domains including risk factor assessment, symptom monitoring, pharmaceutical and non-pharmaceutical management. Results Key recommendations include routine risk profiling before BV initiation, use of validated assessment tools at baseline and throughout therapy, multidisciplinary collaboration, and early intervention for worsening PN. Areas of uncertainty and variability in PN management remain, particularly regarding management of intermediate-grade PN and optimal non-pharmacological strategies. Conclusion These international consensus recommendations provide practical guidance for improving clinical management of BV-induced PN and highlight the importance of early identification, personalised care and multidisciplinary collaboration. Further research is needed to address persistent gaps and inform future clinical guidelines.