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2016, Number 2

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Residente 2016; 11 (2)

Thrombosis in multiple myeloma hemostasis and cytokines involved

Martínez-Acosta G, Zermeño-González ML, Robles-Espinoza AI, Trujillo-Quiros J, Nava-Zavala AH, Rubio-Jurado B

Language: Spanish
References: 60
Page: 71-80
PDF size: 315.80 Kb.


ABSTRACT

Multiple myeloma is a malignancy that arises from a disorder of proliferation of plasma cells, it is characterized by the production of a monoclonal protein in the blood or urine and some organ dysfunction associated. Its clinical manifestations are associated with target organ damage, such as: hypercalcemia, renal failure, anemia and bone lesions. Incidence is 3 to 4 cases per 100,000/h, represents 1% of all malignancies and 10% of the hematological malignancies. Hemostasis is a defense mechanism which seeks to preserve vascular integrity and prevent blood loss by physiological changes leading to the formation of a haemostatic plug, repair damage and eventually dissolve the clot. Occurs concomitantly primary hemostasis (platelet interaction and endothelium) and secondary hemostasis (participation of clotting factors), the cell model of coagulation integrates cell phase. There is a hypercoagulable state in cancer in wich there are interaction of elements of the hemostasis system with tumor cells, endothelium, platelets, monocytes and neutrophils. Procoagulant proteins of cancer, fibrinolytic proteins, cytokines and endothelial growth factors are some of the elements involved. Thromboembolic disease is more common in cancer, with a risk 4.3 times higher than in the general population and in multiple myeloma, up to 30% of patients can present it during its natural history, which is related to the treatment (immunomodulators, steroids, alkylating) and interaction with acquired thrombotic factors.


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