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Abstract(s)
Introdução: O Mieloma MĂșltiplo Ă© a segunda neoplasia hematolĂłgica mais frequente
e afeta predominantemente indivĂduos com mais de 65 anos, com uma idade mĂ©dia ao
diagnóstico de 69 anos. Esta doença resulta no aparecimento de lesÔes de órgão-alvo,
conhecidas pelo acrĂłnimo CRAB, que correspondem a hipercalcemia, lesĂŁo renal,
anemia e lesĂ”es Ăłsseas. Segundo diversos estudos, o mieloma mĂșltiplo em pacientes
jovens apresenta caracterĂsticas clĂnicas distintas em comparação com a população mais
velha com a mesma doença, por isso é necessåria investigação adicional de abordagens
terapĂȘuticas adaptadas.
Objetivo: Este estudo tem como objetivo explorar um caso clĂnico de mieloma mĂșltiplo
de um paciente jovem, contextualizando-o com uma revisĂŁo abrangente da literatura
sobre a doença nessa faixa etåria.
Método: Como metodologia para a realização deste trabalho foi utilizado o motor de
busca PubMed.e foram ainda recolhidas algumas informaçÔes a partir de certas obras
como por exemplo, Harrison's Principles of Internal Medicine. Foram impostos limites
temporais na pesquisa de artigos, à exceção dos artigos referenciados na discussão deste
trabalho, os quais nĂŁo obedeceram a nenhum limite temporal. A prioridade foram
sempre os artigos mais recentes.
Desenvolvimento: O mieloma mĂșltiplo representa a proliferação maligna de
plasmĂłcitos originados de um Ășnico clone. Nos Ășltimos anos, tĂȘm surgido inovaçÔes
significativas na terapĂȘutica do mieloma mĂșltiplo, resultando num aumento
considerĂĄvel da sobrevida dos pacientes. Os pacientes jovens com a doença estĂŁo subrepresentados na literatura, e hĂĄ evidĂȘncias de que apresentam certas caracterĂsticas
clĂnicas distintas ao diagnĂłstico, como a presença de mieloma mĂșltiplo em fases mais
precoces, maior incidĂȘncia de doença de cadeias leves e de doença extramedular. Neste
trabalho foi estudado o caso de um doente de 41 anos que apresentava doença
extramedular, anemia e doença Ăłssea ao diagnĂłstico. O facto de as terapĂȘuticas
administradas não serem as atualmente em vigor, aliado à presença de doença
extramedular e Ă baixa tolerĂąncia a certos fĂĄrmacos utilizados, pode ter tido uma
influĂȘncia negativa na sobrevida deste doente. ConclusĂŁo: O mieloma mĂșltiplo em doentes jovens pode constituir uma entidade
distinta, caracterizada por manifestaçÔes clĂnicas especĂficas. Assim, Ă© crucial realizar estudos adicionais sobre o mieloma mĂșltiplo em jovens adultos, incluindo a
estratificação dos doentes de acordo com o R-ISS, o estudo das anomalias citogenéticas
mais prevalentes e o impacto dos novos esquemas terapĂȘuticos nesta população.
Introduction: Multiple Myeloma is the second most common hematological malignancy, primarily affecting individuals over 65 years old, with an average onset age of 69 years. This disease manifests through specific target organ lesions, collectively known by the acronym CRAB, which stands for hypercalcemia, renal failure, anemia, and bone lesions. Various studies indicate that multiple myeloma presents distinct clinical characteristics in younger patients compared to older individuals with the same condition, highlighting the need for tailored therapeutic approaches for these younger patients. Objective: This study aims to explore a clinical case of multiple myeloma in a young patient and contextualize it within a comprehensive review of the literature on the disease in this age group. Method: The methodology involved utilizing the PubMed search engine and consulting medical manuals, such as Harrison's Principles of Internal Medicine. Temporal limits were applied to the search for articles, with the exception of those referenced in the discussion section, which were not time restricted. Priority was given to the most recent publications. Discussion: Multiple myeloma is characterized by the malignant proliferation of plasma cells originating from a single clone. In recent years, significant advancements in therapy have considerably increased patient survival rates. However, young patients with multiple myeloma are underrepresented in the literature. Evidence suggests they exhibit distinct clinical characteristics at diagnosis, such as earlier-stage disease, a higher incidence of light chain disease, and extramedullary disease. This study examines a 41- year-old patient who presented with extramedullary disease, anemia, and bone disease at diagnosis. The patient's survival may have been negatively impacted by the use of outdated therapies, the presence of extramedullary disease, and low tolerance to certain medications. Conclusion: Multiple myeloma in young patients may constitute a distinct clinical entity characterized by specific manifestations. Therefore, it is crucial to conduct further studies on multiple myeloma in young adults, including patient stratification according to the Revised International Staging System (R-ISS), investigation of prevalent cytogenetic abnormalities, and evaluation of the impact of new therapeutic regimens on this population.
Introduction: Multiple Myeloma is the second most common hematological malignancy, primarily affecting individuals over 65 years old, with an average onset age of 69 years. This disease manifests through specific target organ lesions, collectively known by the acronym CRAB, which stands for hypercalcemia, renal failure, anemia, and bone lesions. Various studies indicate that multiple myeloma presents distinct clinical characteristics in younger patients compared to older individuals with the same condition, highlighting the need for tailored therapeutic approaches for these younger patients. Objective: This study aims to explore a clinical case of multiple myeloma in a young patient and contextualize it within a comprehensive review of the literature on the disease in this age group. Method: The methodology involved utilizing the PubMed search engine and consulting medical manuals, such as Harrison's Principles of Internal Medicine. Temporal limits were applied to the search for articles, with the exception of those referenced in the discussion section, which were not time restricted. Priority was given to the most recent publications. Discussion: Multiple myeloma is characterized by the malignant proliferation of plasma cells originating from a single clone. In recent years, significant advancements in therapy have considerably increased patient survival rates. However, young patients with multiple myeloma are underrepresented in the literature. Evidence suggests they exhibit distinct clinical characteristics at diagnosis, such as earlier-stage disease, a higher incidence of light chain disease, and extramedullary disease. This study examines a 41- year-old patient who presented with extramedullary disease, anemia, and bone disease at diagnosis. The patient's survival may have been negatively impacted by the use of outdated therapies, the presence of extramedullary disease, and low tolerance to certain medications. Conclusion: Multiple myeloma in young patients may constitute a distinct clinical entity characterized by specific manifestations. Therefore, it is crucial to conduct further studies on multiple myeloma in young adults, including patient stratification according to the Revised International Staging System (R-ISS), investigation of prevalent cytogenetic abnormalities, and evaluation of the impact of new therapeutic regimens on this population.
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Keywords
Adulto Jovem Caso ClĂnico Mieloma Multiplo Sobrevida Tratamento