Bases biológicas y moleculares en el desarrollo de la patogenia en la enfermedad del mieloma múltiple // Biological and molecular bases in the development of the pathogenic of the disease of multiple myeloma
Resumen
Resumen
El mieloma múltiple (MM), es una neoplasia de células B clonales con acumulación de células plasmáticas malignas en la médula ósea (MO). Las células mielomatosas secretan una paraproteína monoclonal detectable en el suero y/u orina, y desencadenan un conjunto de alteraciones clínicas en forma de anemia, insuficiencia renal, hipercalcemia o lesiones óseas. El MM representa el 1% de todas las neoplasias, el 10% de las hemopatías malignas y la segunda en orden de presencia. Su incidencia es de 4 casos por cada 100.000 habitantes y año. La mediana de edad para el diagnóstico es de 65 años y de 3 años para la supervivencia. A pesar de los avances en el tratamiento farmacológico y en los trasplantes de MO, el MM sigue siendo una enfermedad incurable. Profundizar en las bases biológicas de los mecanismos patogénicos, el conocimiento de la interacción de la célula plasmática con su micro medioambiente, la descripción de sus características antigénicas, el establecimiento de los factores pronóstico desde el punto de vista molecular, así como de los cambios de expresión génica tras el tratamiento servirá como herramienta para desarrollar futuros enfoques terapéuticos efectivos y específicos frente al MM.
Abstract
Multiple myeloma (MM) is a clonal B-cell neoplasm with accumulation of malignant plasma cells in the bone marrow (BM). The myelomatous cells secrete a monoclonal paraprotein detected in serum and/or urine, and trigger clinical alterations in the form of anemia, renal failure, hypercalcemia or bone lesions. The MM represents 1% of all neoplasms, 10% of malignant hemopathies and the second in order of presence. Its incidence is four cases per 100,000 inhabitants per year. The median age for diagnosis is 65 years and a three year-survival. Despite advances in pharmacological treatment and MO transplants, MM remains an incurable disease. In-depth study of the biological bases of the pathogenic mechanisms, knowledge of the interaction of the plasma cell with its microenvironment, the description of its antigenic characteristics, the establishment of prognostic factors from the molecular point of view, as well as changes in gene expression after treatment, will serve as tools for developing future effective and specific therapeutic approaches against the MM.
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