Mieloma Múltiplo Online (Multiple Myeloma)

¨O mieloma múltiplo (MM) é uma neoplasia maligna hematológica causada pela intensa proliferação indiscriminada de plasmócitos na medula óssea. Define-se mieloma múltiplo (MM) como uma doença maligna e incurável das células B caracterizada pela proliferação de plasmócitos secretores de imunoglobulina monoclonal no sangue ou na urina, o que pode ocorrer como evolução de um quadro de gamopatia monoclonal de significado indeterminado (monoclonal gammopathy of undetermined significance – MGUS). O mieloma corresponde a 10% das neoplasias hematológicas e sua incidência aumenta com a idade, com uma mediana de 67 anos; porém 3% dos pacientes ao diagnóstico possuem idade inferior a 40 anos. Estima-se que a taxa de progressão de MGUS para MM seja de 0,6 a 3% ao ano. O conhecimento da fisiopatologia do mieloma e de suas manifestações clínicas secundárias permitiu que, em 1975, fosse criado o estadiamento de Durie-Salmon (Durie-Salmon stage – DSS). Em 2005, foi publicado o International Staging System (ISS), o qual também propõe três estádios, mas se baseia em marcadores laboratoriais de atividade de doença: beta-2 microglobulina e albumina. O ISS é validado para diversos grupos populacionais, incluindo a população brasileira, e é considerado como forma de estadiamento mais moderna e fidedigna, quando comparado ao DSS. Os avanços na quimioterapia antineoplásica e no transplante de células-tronco hematopoéticas (TCTH) melhoraram as taxas de sobrevivência, mas o mieloma múltiplo permanece incurável. Pessoas com mieloma múltiplo geralmente desenvolvem lesões ósseas, hipercalcemia, anemia, imunossupressão e comprometimento renal, acompanhadas de fadiga, dor óssea e neuropatia periférica (NP). ¨

■ European Myeloma Network recommendations on tools for the diagnosis and monitoring of multiple myeloma: What to use and when

J Caers, L Garderet, K Martin Kortüm et al

Haematologica 2018, vol 103 (11): 1772-1784

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278986/

■ Prevention and management of adverse events of novel agents in multiple myeloma: a consensus of the European Myeloma Networ

H Ludwig, M Delforge, T Facon et al

Leukemia 2018, vol 32 (7): 1542-1560

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035147/

■ Cardiovascular adverse events in moderns myeloma therapy – Incidence and risks. A review from the European Myeloma Network (EMN) and Italian Society of Arterial Hypertension (SIIA

S Bringhen, A Milan, C Ferri et al

Haematologica 2018, vol 103 (9): 1422-1432

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119131/

■ A multiple myeloma classification system tha associates normal B-cell subset phenotypes with prognosis

J S Bodker, R F Brondum, S Schmitz et al

Blood Adv 2018, vol 2 (1): 2400-2411

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6156884/

■ Management of relapsed and refractory multiple myeloma: novel agents, antiboidies, immunotherapies and beyond

C S Chim, S K Kumar, R Z Orlowski, et al

Leukemia 2018, vol 32 (2): 252-262

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808071/

■ Neuropatia periférica em pessoas com mieloma múltiplo.

Moreira, Maysa Mayran Chaves et al.

Acta paul. enferm., Jul 2018, vol.31, no.4, p.439-445

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-21002018000400439&lng=pt&nrm=iso

■ Mesenchymal stem cells in multiple myeloma: a therapeutical tool or target?

S Xu, K De Veirman, A De Becker et al

Leukemia 2018, vol 32 (7): 1500-1514

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035148/

■ From transplant to novel cellular therapies in multiple myeloma: European Myeloma Network guidelines and futures perspectives

F Gay, M Engelhardt, E Terpos et al

Haematologia 2018, vo 103 (2): 197-211

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5792264/

■ Monoclonal antibodies for the treatment of multiple myeloma: an update

H N Abramson

Int J Mol Sci 2018, vol 19 (12): 3924

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6321340/

■ Metabolic features of multiple myeloma

C El Arfani, K De Veirman, K Maes et al

Int J Mol Sci 2018, vol 19 (4): 1200

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979361/

■ Current and new therapeutic strategies for relapsed and refractory multiple myeloma: an update

I S Nijhof, N W C J van de Donk, S Zweegman, H M Lokhorst

Drugs 2018, vol 78 (1): 19-37

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756574/

■ Heavy-chain diseases and myeloma-associated Fanconi syndrome: an update

Ria R, Dammacco F, Vacca A.

Mediterr J Hematol Infect Dis. 2018 Jan 1;10(1):e2018011

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5760076/

■ The biological significance of histone modifiers in multiple myeloma: clinical applications

H Ohguchi, T Hideshima, K C Anderson

Blood Cancer J 2018, vol 8 (9): 83

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127133/

■ Immunotherapy: a novel era of promising treatment for multiple myeloma

M Castella, C F de Larrea, B Martín-Antonio

Int J Mol Sci 2018, vol 19 (11): 3613

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274949/

■ Targeting B cell maturation antigen (BCMA) in multiple myeloma: potential uses of BCMA-based immunotherapy

S Cho, K C Anderson, Y Tai

Front Immunol 2018, vol 9: 1821

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095983/

■ Update on the role of lenalidomide in patients with multiple myeloma

S A Hosltein, V J Suman, P L McCarthy

Ther Adv Hematol 2018, vol 9 (7): 175-190

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041862/

■ Plasmocitoma intraconal e infiltração uveal em paciente portadora de mieloma múltiplo.

Maganhoto, Ana Paula da Silva, Correia, Sara and Pasquarelli Neto, Roberto Ivo

Rev. bras.oftalmol., Fev 2018, vol.77, no.1, p.43-46

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802018000100043&lng=pt&nrm=iso

■ Uterine Extramedullary Plasmacytoma as a Primary Manifestation of Multiple Myeloma.

Codorniz, Ana et al.

Rev. Bras. Ginecol. Obstet., Sept 2017, vol.39, no.9, p.516-520

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032017000900516&lng=pt&nrm=iso&tlng=en

■ Multiple myeloma can be accurately diagnosed in acute kidney injury patients using a rapid serum free light chain test

Jennifer L. J. Heaney, John P. Campbell, Punit Yadav et al

BMC Nephrol. 2017; 18: 247

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520226/

■ A problem with the separating gel in a blood sample tube in a patient with multiple myeloma

Bernd Maire, Kathrin Schlüter

Dtsch Arztebl Int. 2017 Jul; 114(29-30): 507

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569563/

■ Renal toxicities of novel agents used for treatment of multiple myeloma

Rimda Wanchoo, Ala Abudayyeh, Mona Doshi et al

Clin J Am Soc Nephrol. 2017 Jan 6; 12(1): 176–189

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220662/

■ Congestive heart failure with preserved ejection fraction in a patient with light chain (AL) amyloidosis and multiple myeloma

Edgar Francisco Carrizales-Sepúlveda, Alejandro Ordáz-Farías, Raymundo Vera-Pineda et al

Am J Case Rep. 2017; 18: 790–79

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519221/

■ Hypoglossal nerve mononeurathy as the first preseting symptom of progressing multiple myeloma

Neil B. Newman, Vidya Puthenpura, Stephanie Mischell, Gabriela Ferreira

World J Oncol. 2017 Feb; 8(1): 15–17

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624656/

■ Multiple myeloma as the underlying cause of thrombotic microangiopathy leading to acute kidney injury: revising a very rare entity

Savneek Chugh, Asim Kichloo, Firas Jafri et al

J Investig Med High Impact Case Rep. 2017, vol 5(3): 2324709617732797

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613796/

■ The detection of Bence Jones protein in urine by the heat test helps in diagnosis of multiple myeloma?

Tomaz, Ana Paula O. et al.

Bras. Patol. Med. Lab., Feb 2017, vol.53, no.1, p.20-23

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442017000100020&lng=pt&nrm=iso&tlng=en

■ Immunologic approaches for the treatment of multiple myeloma

L Rasche, N Weinhold, G J Morgan et al

Cancer Treat Rev 2017, vol55: 190-199

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604432/

■ Immunomodulatory drugs in multiple myeloma: mechanism of action and clinical experience

S A Holstein, P L McCarthy

Drugs 2017, vol 77 (5): 505-520

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705939/

■ The therapeutic potential of cell cycle targeting in multiple myeloma

A Maes, E Menu, K De Veirman et al

Oncotarget 2017, vol 8 (52): 90501-90520

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685770/

■ Whole body magnetic resonance imaging in newly diagnosed multiple myeloma: early changes in lesional signal fat fraction predict disease response

A Latifoltojar, M Hall-Craggs, N Rabin et al

British Journal of Haematology 2017, vol 176 (2): 222-233

http://onlinelibrary.wiley.com/doi/10.1111/bjh.14401/full

■ Guidelines for the use of imaging in the management of patients with myeloma

A Chantry, M Kazmi, S Barrington et al

British Journal of Haematology 2017, vol 178 (3): 380-393

http://onlinelibrary.wiley.com/doi/10.1111/bjh.14827/full

■ Multiple myeloma: routes to diagnosis, clinical characteristics and survival – findings from a UK population-based study

D Howel, A Smith, S Appleton et al

British Journal of Haematology 2017, vol 177 (1): 67-71

http://onlinelibrary.wiley.com/doi/10.1111/bjh.14513/full

■ Therapy for relapsed multiple myeloma: guidelines from the Mayo stratification for myeloma and riks-adapted therapy

D Dingli, S Ailawadhi, P L Bergsagel et al

Mayo Clin Proc 2017, vol 92(4): 578-598

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5554888/

■ A case of multiple myeloma multiple misdiagnosed as seronegative rheumatoid arthritis an review of relevant literature

Scott Schoninger, Yamen Homsi, Alexandra Kreps, Natasa Milojkvovic

Case Rep Rheumatol. 2018; 2018: 9746241

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201338/

■ Bone-targed agents in multiple myeloma

Hiroko Nishida

Hematol Rep. 2018 Mar 2; 10(1): 740

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5907643/

■ The detection of Bence Jones protein in urine by the heat test helps in diagnosis of multiple myeloma?

Tomaz, Ana Paula O. et al.

Bras. Patol. Med. Lab., Feb 2017, vol.53, no.1, p.20-23

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442017000100020&lng=en&nrm=iso&tlng=en

■ Multiple myeloma presenting as acute liver failure

Stephanie Cull, David J. Westrich, Jr., Ruchi Bhatia et al

ACG Case Rep J. 2017; 4: e85

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496584/

■ Multiple myeloma causing gastric polyposis

Tariq Hammad, Hayder Abdulwahid, Anas Renno et al

ACG Case Rep J. 2017; 4: e98

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559655/

■ Multiple myeloma presenting as acute liver failure

Stephanie Cull, David J. Westrich, Jr., Ruchi Bhatia, Jinping Lai, Alex S. Befeler

ACG Case Rep J. 2017; 4: e85

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496584/

■ Autoimmune hemolytic anemia and hyperglobulinemia leading to the diagnosis of multiple myeloma

Pacca, Rafael Lopes et al.

Rev. Bras. Hematol. Hemoter., Dec 2017, vol.39, no.4, p.357-359

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842017000400357&lng=en&nrm=iso

■ For survival, the emergence of oligoclonal bands after multiple myeloma treatment is less important than achieving complete remission.

Silva, Luiza Soares Vieira da et al.

Rev. Bras. Hematol. Hemoter., Dec 2017, vol.39, no.4, p.331-336

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842017000400331&lng=en&nrm=iso

■ Multiple myeloma and amyloidosis presenting as a restrictive lung disease with respiratory failure

M Pereira, L Afonso, G Fernandes and R Araujo

Case Report 2016, vol 3 (2)

https://clinmedjournals.org/articles/cmrcr/clinical-medical-reviews-and-case-reports-cmrcr-3-091.php?jid=cmrcr

■ Multiple myeloma: patient outcomes in real-world practice

K Yong, M Delforge, C Driessen et al

British Journal of Haematology 2016, vol 175 (2): 252-264

http://onlinelibrary.wiley.com/doi/10.1111/bjh.14213/full

■ Hematopoietic stem cell mobilization for autologous transplantation in multiple myeloma patients previously exposed to cyclophosphamide, thalidomide, and dexamethasone: is granulocyte-colony stimulating factor alone enough?

Vigorito, Afonso Celso.

Rev. Bras. Hematol. Hemoter., Dec 2016, vol.38, no.4, p.281-282

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842016000400281&lng=en&nrm=iso

■ Is it feasible to use granulocyte-colony stimulating factor alone to mobilize progenitor cells in multiple myeloma patients induced with a cyclophosphamide, thalidomide and dexamethasone regimen?

Crusoe, Edvan de Queiroz et al.

Rev. Bras. Hematol. Hemoter., Dec 2016, vol.38, no.4, p.302-30

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842016000400302&lng=en&nrm=iso

■ Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the Internationall Myeloma Working Group

P Sonneyeld, H Avet-Loiseau, S Lonial et al

Blood 2016, vol 127 (24): 2055-2962

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920674/

■ Cardiovascular complications of novel multiple myeloma treatments

W Li, F Cornell, D Lenihan, et al

Circulation 2016, vol 133: 908-912

http://circ.ahajournals.org/content/133/9/908

■ Multiple myeloma: 2016 update on diagnosis, risk-stratification and management

Vincent Rajkumar

Am J Hematol. 2016 Jul; 91(7): 719–734

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291298/

■ Hematological approaches to multiple myeloma: trends from a Brazilian subset of hematologists. A cross-sectional study

Kerbauy, Lucila Nassif et al.

Sao Paulo Med. J., Aug 2016, vol.134, no.4, p.335-341

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802016000400335&lng=pt&nrm=iso&tlng=en

■ Validation of interphase fluorescence in situ hybridization (iFISH) for multiple myeloma using CD138 positive cells.

Kishimoto, Renata Kiyomi et al.

Rev. Bras. Hematol. Hemoter., June 2016, vol.38, no.2, p.113-120

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842016000200113&lng=en&nrm=iso

■ Association of oxidative stress and DNA damage with grafting time in patients with multiple myeloma and lymphoma submitted to autologous hematopoietic stem cell transplantation.

Santos, Thayna Nogueira dos et al.

Rev. Assoc. Med. Bras., Oct 2016, vol.62, suppl.1, p.39-43

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302016001200039&lng=en&nrm=iso&tlng=en

■ Uncemented arthroplasty after hip metastatic disease and multiple myeloma

Baptista, André Mathias et AL

Acta ortop. bras., Aug 2016, vol.24, no.4, p.191-195

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522016000400191&lng=en&nrm=iso

■ Diagnóstico de mieloma múltiple a raíz de una lesión osteolítica mandibular.

Bellotti Mustecic, Marko et al.

Rev Esp Cirug Oral y Maxilofac, Dic 2016, vol.38, no.4, p.213-217

http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-05582016000400213&lng=es&nrm=iso

■ Muliple myeloma in the very elderly patient: challenges and solutions