Alvarado-Ibarra M, Álvarez-Vera JL, Anaya-Cuéllar I, de la Peña-Celaya A, García-Fernández L, Hernández-Ruiz E, Herrera-Olivares W, Leyto-Cruz F, Loera-Fragoso SJ, Martínez-Ríos A, Medina-Coral JE, Mojica-Balceras L, Morales-Adrián JJ, Palafox-Zaldívar MT, Pérez-Zúñiga JM, Ramírez-Moreno EF, Ramos-León EM, Reyes-Brena GN, Rodríguez-Domínguez JR, Romero-Martínez E, Romero-Rodelo H, Saavedra-González A, Silva-Vera K, Tapia-Enríquez AL

Language: Spanish
References: 20
Page: 306-332
PDF size: 704.38 Kb.

ABSTRACT

Multiple myeloma is a disease diagnosed with increasing frequency in hospitals belonging to the Institute for Social Security and Services for State Workers of Mexico (ISSSTE), since with the formation of more and new hematologists distributed in different states of the country, the collection and care of these patients are less late and more efficient. This is reflected in documented unified diagnostic criteria approach, treatment and monitoring of these patients. The multiple myeloma is a malignant entity that is recognized by abnormal proliferation of plasma cells. It is characterized by the presence of bone marrow plasmacytosis, production of monoclonal proteins, osteolytic lesions, renal failure, anemia, hypercalcemia, and immunodeficiency. Multiple myeloma development is a complex process that involves many steps, involving both early and late genetic changes in the tumor cell, and selected conditions that favor optimal microenvironment in the bone marrow for the occurrence of such changes. The treatment of choice includes triplets of combinations that include bortezomib (bortezomib-dexamethasone- cyclophosphamide, bortezomib-dexamethasone-thalidomide or bortezomib-dexamethasone-doxorubicin) with chances of complete response higher than 60%. Autologous transplantation is an option that provides prolonged progression-free survival when this is done with intravenous melphalan and when the patient has reached his/her best response. In cases of progression, lenalidomide and carfilzomib usually offer higher chances of response.

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