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2016, Número 1

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Residente 2016; 11 (1)


Calidad de vida y cuidados en salud en pacientes con mieloma múltiple

Miranda-Ruvalcaba C, Balderas-Peña LMA, Trujillo OJ, Garcés-Ruiz OM, Beatriz-Aguilar L, Nava-Zavala AH, Rubio-Jurado B

Idioma: Español
Referencias bibliográficas: 56
Paginas: 10-18
Archivo PDF: 230.67 Kb.


RESUMEN

El mieloma múltiple (MM) es una neoplasia caracterizada por la proliferación clonal de células plasmáticas, derivadas de las células B de memoria post centrogerminales. Existe infiltración de la médula ósea por células plasmáticas monoclonales, producción de inmunoglobulina clonal y presencia de lesiones líticas. El mieloma múltiple es la segunda neoplasia hematológica más frecuente. Corresponde a 1% de todos los cánceres y 10% de origen hematológico. Incrementa con la edad, encontrándose la mediana en los 69 años; pero un tercio de los pacientes se encuentra en edad menor de 60 años. En los países occidentales la incidencia es 5.6 casos por cada 100,000 habitantes. En al año 2011, en Estados Unidos se presentaron 20,520 casos nuevos de mieloma múltiple. En México, se registraron 597 casos nuevos en el año 2002, cifra que se incrementa a 1,068 en 2006, correspondiendo al 1.01%. Hay dos aspectos importantes en la patogénesis del mieloma múltiple, la estrecha interacción de las células de mieloma con las células del estroma de la médula ósea, necesaria para la supervivencia, crecimiento y diferenciación de las células plasmáticas, y alteraciones genéticas iniciales y secundarias que influyen en las manifestaciones clínicas de la enfermedad. Algunas citocinas están implicadas en la fisiopatología del mieloma múltiple; éstas son producidas por células de tipo T y están implicadas en la proliferación y la diferenciación de linfocitos B humanos. La calidad de vida es sinónimo de la percepción del paciente de su enfermedad y síntomas que interfieren con su vida diaria. La enfermedad y el tratamiento influyen sobre los síntomas y aspectos generales del paciente. Los principales aspectos que afectan la calidad de vida son fatiga, dolor y síntomas depresivos, los pacientes con mieloma múltiple muestran más síntomas en comparación con otros padecimientos. El cuestionario de calidad de vida relacionada con la salud en pacientes con cáncer es la escala QLQ-C30 de la Organización Europea para la Investigación y Tratamiento del Cáncer (EORTC); evalúa el estado físico, emocional, funcionamiento cognitivo y social. El módulo para mieloma múltiple es la QLQ MY 20; evalúa síntomas, efectos secundarios, una escala funcional y la imagen corporal. El presente trabajo expone la importancia de la calidad de vida y percepción de la atención del paciente como parte integral del tratamiento médico.


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