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Publication
Mieloma múltiplo: evolução dos tratamentos
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Advisor(s)
Abstract(s)
O Mieloma Múltiplo é uma neoplasia das células plasmáticas e é o segundo cancro de origem hematológica mais comum. A sua incidência aumenta com a idade, atingindo o seu pico aos 69 anos, e afeta maioritariamente o sexo masculino e os afrodescendentes.
Esta neoplasia, surge na medula óssea e caracteriza-se por uma expansão clonal de plasmócitos neoplásicos que produzem anticorpos monoclonais não funcionais. A acumulação destes anticorpos monoclonais no organismo pode desencadear diversos problemas de saúde, tais como hipercalcemia, insuficiência renal, anemia e lesões ósseas.
O Mieloma Múltiplo é a doença hematológica que tem um maior número de fármacos aprovados. Inicialmente, o tratamento desta neoplasia baseava-se em regimes de quimioterapia que englobavam agentes alquilantes, imunomoduladores e inibidores de proteossoma. A partir do ano de 2015, com a aprovação do Daratumumab (anticorpo monoclonal anti-CD38) surgiu a era da imunoterapia. Esta era veio revolucionar completamente o paradigma terapêutico do Mieloma Múltiplo melhorando exponencialmente os resultados terapêuticos e a qualidade de vida dos doentes.
O tratamento desta neoplasia é aplicado para dois grupos de doentes, os elegíveis para transplante autólogo de progenitores hematopoiéticos e os não elegíveis. A eleição para a realização do transplante tem em conta a idade do doente, as suas comorbilidades, o seu estado de desempenho e a sua resiliência funcional.
Para além dos tratamentos principais, é importante que os pacientes adotem medidas de autocuidado e realizem tratamentos complementares. Esta associação melhora a qualidade de vida dos doentes com Mieloma Múltiplo.
Apesar do sucesso que os tratamentos atuais apresentam, o Mieloma Múltiplo continua sem cura. Deste modo, estão a decorrer estudos que envolvem imunoterapia, tratamentos dirigidos e nanotecnologia para desenvolver novos tratamentos.
Multiple Myeloma is a neoplasm of the plasma cells and is the second most common cancer of hematological origin. Its incidence increases with age, peaking at 69, and it mostly affects males and people of African descent. This neoplasm arises in the bone marrow and is characterized by a clonal expansion of neoplastic plasma cells that produce non-functional monoclonal antibodies. The accumulation of these monoclonal antibodies in the body can trigger various health problems, such as hypercalcemia, kidney failure, anemia and bone lesions. Multiple Myeloma is the hematological disease with the largest number of approved drugs. Initially, the treatment of this neoplasm was based on chemotherapy regimens that included alkylating agents, immunomodulators and proteosome inhibitors. In 2015, with the approval of Daratumumab (an anti-CD38 monoclonal antibody), the era of immunotherapy dawned. This era has completely revolutionized the therapeutic paradigm for Multiple Myeloma, exponentially improving therapeutic results and patients' quality of life. The treatment of this neoplasm is applied to two groups of patients, those eligible for autologous transplantation of hematopoietic progenitors and those not eligible. The choice of transplant takes into account the patient's age, comorbidities, performance status and functional resilience. In addition to the main treatments, it is important for patients to adopt self-care measures and carry out complementary treatments. This combination improves the quality of life of Multiple Myeloma patients. Despite the success of current treatments, Multiple Myeloma still has no cure. Studies involving immunotherapy, targeted therapies and nanotechnology are therefore underway to develop new treatments.
Multiple Myeloma is a neoplasm of the plasma cells and is the second most common cancer of hematological origin. Its incidence increases with age, peaking at 69, and it mostly affects males and people of African descent. This neoplasm arises in the bone marrow and is characterized by a clonal expansion of neoplastic plasma cells that produce non-functional monoclonal antibodies. The accumulation of these monoclonal antibodies in the body can trigger various health problems, such as hypercalcemia, kidney failure, anemia and bone lesions. Multiple Myeloma is the hematological disease with the largest number of approved drugs. Initially, the treatment of this neoplasm was based on chemotherapy regimens that included alkylating agents, immunomodulators and proteosome inhibitors. In 2015, with the approval of Daratumumab (an anti-CD38 monoclonal antibody), the era of immunotherapy dawned. This era has completely revolutionized the therapeutic paradigm for Multiple Myeloma, exponentially improving therapeutic results and patients' quality of life. The treatment of this neoplasm is applied to two groups of patients, those eligible for autologous transplantation of hematopoietic progenitors and those not eligible. The choice of transplant takes into account the patient's age, comorbidities, performance status and functional resilience. In addition to the main treatments, it is important for patients to adopt self-care measures and carry out complementary treatments. This combination improves the quality of life of Multiple Myeloma patients. Despite the success of current treatments, Multiple Myeloma still has no cure. Studies involving immunotherapy, targeted therapies and nanotechnology are therefore underway to develop new treatments.
Description
Keywords
Mieloma múltiplo Anticorpo monoclonal Plasmócitos Imunoterapia Tratamento