Mieloma múltiple: consideraciones especiales al diagnóstico

  • Christian Ramos-Peñafiel Departamento de Hematología, Hospital General de México “Dr. Eduardo Liceaga”. Ciudad de México, México
  • Cristina Madera-Maldonado Departamento de Hematología, Hospital General de México “Dr. Eduardo Liceaga”. Ciudad de México, México
  • Adrián Santoyo Sánchez Hospital General de México https://orcid.org/0000-0003-0672-0159
  • Erika Rojas-González Departamento de Nutrición clínica, Hospital General de México “Dr. Eduardo Liceaga”. Ciudad de México, México.
  • Irma Olarte-Carrillo Laboratorio de Biología Molecular, Hospital General de México “Dr. Eduardo Liceaga”. Ciudad de México, México
  • Adolfo Martínez-Tovar Laboratorio de Biología Molecular, Hospital General de México “Dr. Eduardo Liceaga”. Ciudad de México, México
  • Juan Collazo-Jaloma Departamento de Hematología, Hospital General de México “Dr. Eduardo Liceaga”. Ciudad de México, México
Palabras clave: Mieloma multiple, Anemia, Diagnóstico

Resumen

El mieloma múltiple (MM) es una neoplasia originada de células B secundaria a diversas mutaciones post-germinales y cuya característica es el desarrollo de una clona de células plasmáticas que secretan un subtipo específico de inmunoglobulina conocido como el componente monoclonal. Dentro de las manifestaciones clínicas más comunes se encuentran tanto la anemia, la enfermedad renal y las lesiones óseas, pero cada vez son más los casos que muestran al diagnóstico manifestaciones clínicas atípicas que pueden influir con el pronóstico y con la calidad de vida. Debido a que el tratamiento moderno del MM es altamente prometedor, es necesario identificar aquellas condiciones clínicas que limiten la eficacia terapéutica.

Descargas

La descarga de datos todavía no está disponible.

Biografía del autor/a

Adrián Santoyo Sánchez, Hospital General de México

MDMédicoCirujano.Hospital General de México,

Referencias

Rajkumar SV. Multiple myeloma: 2018 update on diagnosis, risk-stratification, and management. Am. J. Hematol. 2018;93(8):1091-1110. doi:10.1002/ajh.25117.

Rajkumar S V. Evolving diagnostic criteria for multiple myeloma. Hematology 2015;2015(1):272-278. doi:10.1182/asheducation-2015.1.272.

Gerecke C, Fuhrmann S, Strifler S, Schmidt-Hieber M, Einsele H, Knop S. The Diagnosis and Treatment of Multiple Myeloma. Dtsch. Aerzteblatt Online 2016;113(27-28):470-6. doi:10.3238/arztebl.2016.0470.

Silbermann R, Roodman GD. Myeloma bone disease: Pathophysiology and management. J. bone Oncol. 2013;2(2):59-69. doi:10.1016/j.jbo.2013.04.001.

Kazandjian D. Multiple myeloma epidemiology and survival: A unique malignancy. Semin. Oncol. 2016;43(6):676-681. doi:10.1053/j.seminoncol.2016.11.004.

Cowan AJ, Allen C, Barac A, Basaleem H, Bensenor I, Curado MP, et al. Global Burden of Multiple Myeloma: A Systematic Analysis for the Global Burden of Disease Study 2016. JAMA Oncol. 2018;4(9):1221-1227. doi:10.1001/jamaoncol.2018.2128.

Zweegman S, Palumbo A, Bringhen S, Sonneveld P. Age and aging in blood disorders: multiple myeloma. Haematologica 2014;99(7):1133-7. doi:10.3324/haematol.2014.110296.

Curado MP, Oliveira MM, Silva DRM, Souza DLB. Epidemiology of multiple myeloma in 17 Latin American countries: an update. Cancer Med. 2018;7(5):2101-2108. doi:10.1002/cam4.1347.

Ruiz-Argüelles GJ, Ramírez-Cisneros FJ, Flores-Martínez J, Cernuda-Graham MC. Waldenström’s macroglobulinemia is infrequent in Mexican Mestizos: experience of a hematological diseases referral center. Rev. Invest. Clin. 2000;52(5):497-9. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/11195177. Consultado: 9 November 2018.

Colunga-Pedraza PR, Gomez-Cruz GB, Colunga-Pedraza JE, Ruiz-Argüelles GJ. Geographic Hematology: Some Observations in Mexico. Acta Haematol. 2018;140(2):114-120. doi:10.1159/000491989.

Talamo G, Farooq U, Zangari M, Liao J, Dolloff NG, Loughran TP, et al. Beyond the CRAB symptoms: a study of presenting clinical manifestations of multiple myeloma. Clin. Lymphoma. Myeloma Leuk. 2010;10(6):464-8. doi:10.3816/CLML.2010.n.080.

Nakaya A, Fujita S, Satake A, Nakanishi T, Azuma Y, Tsubokura Y, et al. Impact of CRAB Symptoms in Survival of Patients with Symptomatic Myeloma in Novel Agent Era. Hematol. Rep. 2017;9(1):6887. doi:10.4081/hr.2017.6887.

Rajkumar SV. Multiple myeloma: 2016 update on diagnosis, risk-stratification, and management. Am. J. Hematol. 2016;91(7):719-734. doi:10.1002/ajh.24402.

Ludwig H, Pohl G, Osterborg A. Anemia in multiple myeloma. Clin. Adv. Hematol. Oncol. 2004;2(4):233-41. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/16163188. Consultado: 5 November 2018.

Beguin Y. Erythropoiesis and Erythropoietin in Multiple Myeloma. Leuk. Lymphoma 1995;18(5-6):413-421. doi:10.3109/10428199509059639.

Hutchison EJ, Taverna JA, Yu Q, Yeager AM. Polycythaemia: an unusual presentation of multiple myeloma. BMJ Case Rep. 2016;2016:bcr2016216686. doi:10.1136/bcr-2016-216686.

Birgegård G, Gascón P, Ludwig H. Evaluation of anaemia in patients with multiple myeloma and lymphoma: findings of the European CANCER ANAEMIA SURVEY. Eur. J. Haematol. 2006;77(5):378-86. doi:10.1111/j.1600-0609.2006.00739.x.

Mittelman M. The implications of anemia in multiple myeloma. Clin. Lymphoma 2003;4(Suppl 1):S23-9. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/14556675. Consultado: 5 November 2018.

Ludwig H. Anemia of hematologic malignancies: what are the treatment options? Semin. Oncol. 2002;29(3 Suppl 8):45-54. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/12082654. Consultado: 5 November 2018.

Ludwig H, Zojer N. Supportive therapy in multiple myeloma. Recent Results Cancer Res. 2011;183:307-33. doi:10.1007/978-3-540-85772-3_15.

Mohty B, El-Cheikh J, Yakoub-Agha I, Moreau P, Harousseau J-L, Mohty M. Peripheral neuropathy and new treatments for multiple myeloma: background and practical recommendations. Haematologica 2010;95(2):311-9. doi:10.3324/haematol.2009.012674.

Brioli A, Mügge L-O, Hochhaus A, Von Lilienfeld-Toal M. Safety issues and management of toxicities associated with new treatments for multiple myeloma. Expert Rev. Hematol. 2017;10(3):193-205. doi:10.1080/17474086.2017.1284584.

Luczkowska K, Litwinska Z, Paczkowska E, Machalinski B. Pathophysiology of drug-induce peripheral neuropathy in patients with multiple myeloma. J. Physiol. Pharmacol. 2018;69(2). doi:10.26402/jpp.2018.2.02.

Dispenzieri A, Kyle RA. Neurological aspects of multiple myeloma and related disorders. Best Pract. Res. Clin. Haematol. 2005;18(4):673-688. doi:10.1016/j.beha.2005.01.024.

Drappatz J, Batchelor T. Neurologic complications of plasma cell disorders. Clin. Lymphoma 2004;5(3):163-71. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/15636691. Consultado: 9 November 2018.

Eroğlu A, Sarı E, Topuz AK, Şimşek H, Pusat S. Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes. World J. Clin. Cases 2018;6(10):365-372. doi:10.12998/wjcc.v6.i10.365.

Elsaman AM, Radwan AR, Akmatov MK, Della Beffa C, Walker A, Mayer CT, et al. Amyloid arthropathy associated with multiple myeloma: a systematic analysis of 101 reported cases. Semin. Arthritis Rheum. 2013;43(3):405-12. doi:10.1016/j.semarthrit.2013.07.004.

Cesarman-Maus G, Braggio E, Fonseca R. Thrombosis in multiple myeloma (MM). Hematology 2012;17(Suppl 1):S177-80. doi:10.1179/102453312X13336169156933.

Leal AC, Mizurini DM, Gomes T, Rochael NC, Saraiva EM, Dias MS, et al. Tumor-Derived Exosomes Induce the Formation of Neutrophil Extracellular Traps: Implications For The Establishment of Cancer-Associated Thrombosis. Sci. Rep. 2017;7(1):6438. doi:10.1038/s41598-017-06893-7.

Rao AN, Kazzaz NM, Knight JS. Do neutrophil extracellular traps contribute to the heightened risk of thrombosis in inflammatory diseases? World J. Cardiol. 2015;7(12):829-42. doi:10.4330/wjc.v7.i12.829.

Larocca A, Cavallo F, Bringhen S, Di Raimondo F, Falanga A, Evangelista A, et al. Aspirin or enoxaparin thromboprophylaxis for patients with newly diagnosed multiple myeloma treated with lenalidomide. Blood 2012;119(4):933-939. doi:10.1182/blood-2011-03-344333.

Gogia A, Sikka M, Sharma S, Rusia U. Hemostatic Abnormalities in Multiple Myeloma Patients. Asian Pac. J. Cancer Prev. 2018;19(1):127-130. doi:10.22034/APJCP.2018.19.1.127.

Napolitano M, Raso S, Lanza-Cariccio MR, Carlisi M, Mancuso S, Lipari MG, et al. Acquired Hemophilia A as Early Manifestation of Multiple Myeloma: A Case Report. J. Hematol. Mult. Myeloma 2017;2(1):1006.

Melton LJ, Kyle RA, Achenbach SJ, Oberg AL, Rajkumar SV. Fracture Risk With Multiple Myeloma: A Population-Based Study. J. Bone Miner. Res. 2004;20(3):487-493. doi:10.1359/JBMR.041131.

Hansford BG, Silbermann R. Advanced Imaging of Multiple Myeloma Bone Disease. Front. Endocrinol. (Lausanne). 2018;9:436. doi:10.3389/fendo.2018.00436.

Roux S, Mariette X. The High Rate of Bone Resorption in Multiple Myeloma is due to RANK (Receptor Activator of Nuclear Factor-κB) and RANK Ligand Expression. Leuk. Lymphoma 2004;45(6):1111-1118. doi:10.1080/10428194310001593193.

Roodman GD. Role of the bone marrow microenvironment in multiple myeloma. J. Bone Miner. Res. 2002;17(11):1921-5. doi:10.1359/jbmr.2002.17.11.1921.

Melton LJ, Rajkumar SV, Khosla S, Achenbach SJ, Oberg AL, Kyle RA. Fracture risk in monoclonal gammopathy of undetermined significance. J. Bone Miner. Res. 2004;19(1):25-30. doi:10.1359/JBMR.0301212.

Cossu G, Terrier L-M, Benboubker L, Destrieux C, Velut S, François P, et al. Spinal metastases in multiple myeloma: A high-risk subgroup for ISS III patients. Surg. Oncol. 2018;27(2):321-326. doi:10.1016/j.suronc.2018.05.005.

Leithner A, Radl R, Gruber G, Hochegger M, Leithner K, Welkerling H, et al. Predictive value of seven preoperative prognostic scoring systems for spinal metastases. Eur. Spine J. 2008;17(11):1488-1495. doi:10.1007/s00586-008-0763-1.

Sethi S, Fervenza FC, Rajkumar SV. Spectrum of manifestations of monoclonal gammopathy-associated renal lesions. Curr. Opin. Nephrol. Hypertens. 2016;25(2):127-37. doi:10.1097/MNH.0000000000000201.

Doshi M, Lahoti A, Danesh FR, Batuman V, Sanders PW, American Society of Nephrology Onco-Nephrology Forum. Paraprotein-Related Kidney Disease: Kidney Injury from Paraproteins-What Determines the Site of Injury? Clin. J. Am. Soc. Nephrol. 2016;11(12):2288-2294. doi:10.2215/CJN.02560316.

Motwani SS, Herlitz L, Monga D, Jhaveri KD, Lam AQ, American Society of Nephrology Onco-Nephrology Forum. Paraprotein–Related Kidney Disease: Glomerular Diseases Associated with Paraproteinemias. Clin. J. Am. Soc. Nephrol. 2016;11(12):2260-2272. doi:10.2215/CJN.02980316.

Manohar S, Nasr SH, Leung N. Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney-What We Know and What the Future May Hold. Curr. Hematol. Malig. Rep. 2018;13(3):220-226. doi:10.1007/s11899-018-0451-0.

Ying W-Z, Wang P-X, Aaron KJ, Basnayake K, Sanders PW. Immunoglobulin light chains activate nuclear factor-κB in renal epithelial cells through a Src-dependent mechanism. Blood 2011;117(4):1301-7. doi:10.1182/blood-2010-08-302505.

Basnayake K, Ying W-Z, Wang P-X, Sanders PW. Immunoglobulin Light Chains Activate Tubular Epithelial Cells through Redox Signaling. J. Am. Soc. Nephrol. 2010;21(7):1165-1173. doi:10.1681/ASN.2009101089.

Kurien AA, Fernando ME. Amyloid Proximal Tubulopathy and Amyloid Casts: An Unusual Finding in Multiple Myeloma. Indian J. Nephrol. 2018;28(2):160-163. doi:10.4103/ijn.IJN_297_16.

Messiaen T, Deret S, Mougenot B, Bridoux F, Dequiedt P, Dion JJ, et al. Adult Fanconi syndrome secondary to light chain gammopathy. Clinicopathologic heterogeneity and unusual features in 11 patients. Medicine (Baltimore). 2000;79(3):135-54. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/10844934. Consultado: 9 November 2018.

Ma CX, Lacy MQ, Rompala JF, Dispenzieri A, Rajkumar SV, Greipp PR, et al. Acquired Fanconi syndrome is an indolent disorder in the absence of overt multiple myeloma. Blood 2004;104(1):40-2. doi:10.1182/blood-2003-10-3400.

Hellmark T, Segelmark M. Diagnosis and classification of Goodpasture’s disease (anti-GBM). J. Autoimmun. 2014;48-49:108-112. doi:10.1016/j.jaut.2014.01.024.

Hildebrand AM, Huang S-HS, Clark WF. Plasma Exchange for Kidney Disease: What Is the Best Evidence? Adv. Chronic Kidney Dis. 2014;21(2):217-227. doi:10.1053/j.ackd.2014.01.008.

Sieberth HG, Gloeckner W, Borberg H, Fohlmeister J. Plasma separation in Goodpasture’s syndrome and multiple myeloma. Proc. Eur. Dial. Transplant Assoc. 1979;16:528-34. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/548997. Consultado: 11 November 2018.

Rathore R, Coward RA, Woywodt A. What’s in a name? Bence Jones protein. Clin. Kidney J. 2012;5(5):478-83. doi:10.1093/ckj/sfs127.

Ribatti D. The discovery of plasma cells: An historical note. Immunol. Lett. 2017;188:64-67. doi:10.1016/j.imlet.2017.06.006.

Sridevi HB, Rai S, Suresh PK, Somesh MS, Minal J. Pancytopenia in Multiple Myeloma- An Enigma: Our Experience from Tertiary Care Hospital. J. Clin. Diagn. Res. 2015;9(11):EC04-6. doi:10.7860/JCDR/2015/12788.6718.

Fantl D, Curutchet M del C, Kusminsky G, Labanca V, Orlando S, Quiroga L, et al. Mieloma Múltiple. 2012. Disponible en: http://sah.org.ar/docs/289-316.6.SAH_GUIA2012_MielomaMultiple.pdf.

Alvarado-Ibarra M, Álvarez-Vera JL, Anaya-Cuéllar I, Peña-Celaya A de la, García-Fernández L, Hernández-Ruiz E, et al. Primer Consenso Nacional de Mieloma Múltiple por Hematólogos del ISSSTE. Rev Hematol Mex 2015;16:306-332.

Publicado
2021-03-26
Cómo citar
[1]
Ramos-Peñafiel, C., Madera-Maldonado , C., Santoyo Sánchez, A., Rojas-González , E., Olarte-Carrillo , I., Martínez-Tovar , A. y Collazo-Jaloma , J. 2021. Mieloma múltiple: consideraciones especiales al diagnóstico. Revista Colombiana de Cancerología. 25, 2 (mar. 2021).
Sección
Artículos de revisión