Concentración de cadenas ligeras libres en el suero y relación con algunas características de pacientes con mieloma múltiple
Palabras clave:
mieloma múltiple, concentración de sLFC, sFLCκ, sFLCλ.Resumen
Introducción: La cuantificación de cadenas ligeras libres en el suero es una prueba valiosa para determinar el riesgo al momento del diagnóstico del mieloma múltiple, así como evaluar la respuesta al tratamiento y monitorear la recurrencia.Objetivo: Determinar las características de la concentración de cadenas ligeras libres en el suero y su relación con algunas características clínicas y subclínicas en pacientes con mieloma múltiple.
Métodos: Se realizó un estudio descriptivo, retrospectivo, no controlado, en 74 pacientes con mieloma múltiple. Todos los pacientes completaron pruebas cuantitativas de cadena ligera libre en el suero κ y cadena ligera libre en suero λ.
Resultados: El mieloma múltiple de inmunoglobulina intacta representó a la mayoría de los pacientes (81 %). La mayoría de los pacientes tenían cadenas ligeras libres séricas anormales en el momento del diagnóstico (98,6 %). La concentración elevada de cadenas ligeras libres en el suero correlacionó con concentración de proteína M > 3 g/dL (p< 0,05) y no hubo correlación estadísticamente significativa entre cadenas ligeras libres en el suero elevadas y otras características clínicas y subclínicas.
Conclusión: La mayoría de los pacientes con mieloma múltiple tienen cadenas ligeras libres séricas elevadas en el momento del ingreso. Se observa correlación de cadenas ligeras libres séricas altas, con la proteína M sérica aumentada.
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2. Kyle RA, Rajkumar SV. Erratum: Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leukemia. 2014 [access: 09/08/2014]; 28(4):980. Available at: https://www.nature.com/articles/leu201411
3. Dimopoulos M, Kyle R, Fermand JP, Rajkumar SV, San MJ, Chanan-Khan A, et al. Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3. Blood, The Journal of the American Society of Hematology. 2011 [access: 05/05/2011]; 117(18):4701-5. Available at: https://ashpublications.org/blood/article/117/18/4701/21362/Consensus-recommendations-for-standard
4. Jenner E. Serum free light chains in clinical laboratory diagnostics. Clinica Chimica Acta. 2014 [access: 01/01/2014]; 427:15-20. Available at: https://www.sciencedirect.com/science/article/pii/S0009898113003288
5. García de Veas Silva JL, Bermudo GC, Menéndez VP, Rojas Noboa JC, Kestler K, Duro MR. Prognostic value of serum free light chains measurements in multiple myeloma patients. PloS one. 2014 [access: 28/11/2016]; 11(11):e0166841. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166841
6. Thanh Thanh S. Research for Clinical Features of Multiple myeloma at Hematology Department of Cho Ray Hospital. Medical Journal of Ho Chi Minh City. 2011 [access: 01/11/2011]; 15(4):259-66. Available at: https://yhoctphcm.ump.edu.vn/index.php?Content=ChiTietBai&idBai=6430
7. Ngoc LB, Monivong Cheanh BS. Treatment efficacy of Bortezomib, Cyclophosphamide and Dexamethasone (VCD) regimens in multiple myeloma patients with renal impairment. Vietnam Medical Journal. 2021 [access: 05/08/2021]; 505(2): 101-05. Available at: https://tapchiyhocvietnam.vn/index.php/vmj/article/view/1101/961
8. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Altekruse SF, et al. SEER cancer statistics review, 1975-2009 (vintage 2009 populations). National Cancer Institute; 2012. [access: 05/08/2021]. Available at: https://seer.cancer.gov/archive/csr/1975_2009_pops09/
9. Palumbo A, Bringhen S, Ludwig H, Dimopoulos MA, Bladé J, Mateos MV, et al. Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN). Blood, The Journal of the American Society of Hematology. 2011 [access: 27/10/2011]; 118(17):4519-29. Available at: https://ashpublications.org/blood/article/118/17/4519/29031/Personalized-therapy-in-multiple-myeloma-according
10. Bora K. Distribution of multiple myeloma in India: Heterogeneity in incidence across age, sex and geography. Cancer epidemiology. 2019 [access: 01/04/2019]; 59:215-20. Available at: https://www.sciencedirect.com/science/article/abs/pii/S1877782118307173
11. Lee BH, Shin SH, Min CK, Yhim HY, Kwak JY, Kim JA. Role of high-dose melphalan with autologous stem cell transplantation in multiple myeloma patients receiving botezomib-containing induction therapy. International journal of hematology. 2013 [access: 20/04/2013]; 97(5):634-39. Available at: https://link.springer.com/article/10.1007/s12185-013-1311-2
12. Khanh BQ. Study on Autologous stem cell transplantation in treatment of Multiple Myeloma and non-Hodgkin Lymphoma. PhD thesis, Hanoi Medical University; 2014. [access: 20/01/2015]. Available at: https://sdh.hmu.edu.vn/news/cID97_nghien-cuu-hieu-qua-cua-ghep-te-bao-goc-tu-than-dieu-tri-benh-da-u-tuy-xuong-va-u-lympho-ac-tinh-khong-hodgkin.html
13. Mori S, Crawford BS, Roddy JV, Phillips G, Elder P, Hofmeister CC, et al. Serum free light chains in myeloma patients with an intact M protein by immunofixation: potential roles for response assessment and prognosis during induction therapy with novel agents. Hematological oncology. 2011 [access: 26/11/2011]; 30(3):156-162. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1002/hon.1019
14. Tacchetti P, Cavo M, Rocchi S, Pezzi A, Pantani L, Brioli A, et al. Prognostic impact of serial measurements of serum-free light chain assay throughout the course of newly diagnosed multiple myeloma treated with bortezomib-based regimens. Leukemia & lymphoma. 2016 [access: 23/01/2017]; 57(9):2058-64. Available at: https://www.tandfonline.com/doi/abs/10.3109/10428194.2015.1124994
15. Wang L, Jin FY, Li Y, Sun JN, Zhang JJ, Tang R, et al. IgA type multiple myeloma, clinical features, and prognosis. Chinese medical journal. 2018 [access: 28/05/2018]; 131(10):1249-50. Available at: https://mednexus.org/doi/full/10.4103/0366-6999.231513
16. Alhaj Moustafa M, Rajkumar SV, Dispenzieri A, Gertz MA, Lacy MQ, Buadi FK, et al. Utility of serum free light chain measurements in multiple myeloma patients not achieving complete response to therapy. Leukemia. 2015 [access: 12/05/2015]; 29(10):2033-38. Available at: https://www.nature.com/articles/leu2015118
17. Rafae A, Malik MN, Zar MA, Durer S, Durer C. An Overview of Light Chain Multiple Myeloma: Clinical Characteristics and Rarities, Management Strategies, and Disease Monitoring. Cureus. 2018 [access: 15/08/2018]; 10(8):[aprox. 17 scr.]. Available at: https://www.cureus.com/articles/13514-an-overview-of-light-chain-multiple-myeloma-clinical-characteristics-and-rarities-management-strategies-and-disease-monitoring
18. Ramakrishnan N, Jialal I. Bence-Jones Protein. Treasure Island: StatPearls Publishing; 2019. [access: 11/08/2019]. Available at: https://europepmc.org/article/NBK/nbk541035
19. Dejoie T, Corre J, Caillon H, Hulin C, Perrot A, Caillot D, et al. Serum free light chains, not urine specimens, should be used to evaluate response in light-chain multiple myeloma. Blood, The Journal of the American Society of Hematology. 2016 [access: 22/12/2016]; 128(25):2941-48. Available at: https://ashpublications.org/blood/article/128/25/2941/35690/Serum-free-light-chains-not-urine-specimens-should
20. Sthaneshwar P, Nadarajan V, Maniam JA, Nordin N, Gin GG. Serum free light chains: diagnostic and prognostic value in multiple myeloma. Clinical Chemistry and Laboratory Medicine. 2009 [access: 26/06/2009]; 47(9):1101-07. Available at: https://www.degruyter.com/document/doi/10.1515/CCLM.2009.260/html
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Publicado
01.01.2023
Cómo citar
1.
Phan VN-T, Cao LT, Tong MD, Nguyen TH, Tran KV, Le DT. Concentración de cadenas ligeras libres en el suero y relación con algunas características de pacientes con mieloma múltiple. Rev Cubana Med Milit [Internet]. 1 de enero de 2023 [citado 1 de abril de 2025];52(1):e02302354. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/2354
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