{"id":2550,"date":"2009-03-02T02:33:35","date_gmt":"2009-03-02T02:33:35","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/hemmm\/"},"modified":"2025-05-14T19:11:26","modified_gmt":"2025-05-14T19:11:26","slug":"hemmm","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/hemmm\/","title":{"rendered":"Criterios Diagn\u00f3stico para Mieloma M\u00faltiple"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div class=\"Section1\">\n<p style=\"font-weight: 400;\">Presencia de componente M<sup>a<\/sup>\u00a0en suero y\/o en orina m\u00e1s c\u00e9lulas plasm\u00e1ticas monoclonales en m\u00e9dula \u00f3sea y\/o un plasmacitoma clonal documentado.<\/p>\n<p><!--more--><\/p>\n<p style=\"font-weight: 400;\">M\u00c1S uno o m\u00e1s de los siguientes:<sup>b<\/sup><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Elevaci\u00f3n del calcio (&gt;11.5 mg\/dl) [&gt;2.65 mmol\/l]<\/li>\n<li>Insuficiencia renal (creatinina &gt;2 mg\/dl) [177 mmol\/l o m\u00e1s]<\/li>\n<li>Anemia (hemoglobina &lt;10 g\/dl o 2 g\/dl &lt;normal) (hemoglobina &lt;12.5 mmol\/l<sup>c<\/sup>\u00a0o 1.25 mmol\/l &lt;normal)<\/li>\n<li>Enfermedad \u00f3sea (lesiones l\u00edticas u osteopenia)<\/li>\n<\/ul>\n<p style=\"font-weight: 400;\"><sup>a<\/sup>En pacientes con componente M no detectable, una relaci\u00f3n s\u00e9rica anormal de cadenas livianas libres en la prueba s\u00e9rica de cadenas livianas libres puede sustituir y satisfacer este criterio. Para pacientes, sin componente M s\u00e9rico o urinario y relaci\u00f3n de cadenas livianas libres normal, la m\u00e9dula \u00f3sea basal deber\u00eda presentar\u00a0<u>&gt;<\/u>10% c\u00e9lulas plasm\u00e1ticas clonales; estos pacientes son referidos como que presentan \u2018mieloma no secretor\u2019. Los pacientes con biopsia que certifica amiloidosis y\/o enfermedad sist\u00e9mica por dep\u00f3sito de cadenas livianas (LCDD) deber\u00eda ser clasificado como \u2018mieloma con amiloidosis documentada \u2019 o \u2018mieloma con LCDD documentada,\u2019 respectivamente si tienen\u00a0<u>&gt;<\/u>30% de c\u00e9lulas plasm\u00e1ticas y\/o enfermedad \u00f3sea relacionada al mieloma.<\/p>\n<p style=\"font-weight: 400;\"><sup>b<\/sup>Deber\u00eda ser atribuido a la enfermedad de c\u00e9lulas plasm\u00e1ticas subyacente.<\/p>\n<p style=\"font-weight: 400;\"><sup>c<\/sup>Nota: Hemoglobina de 10 g\/dl es 12.5 mmol\/l [o 100 g\/l].<\/p>\n<p>&nbsp;<\/p>\n<p style=\"font-weight: 400;\"><strong>Disfunci\u00f3n org\u00e1nica relacionadas con Mieloma (criterios CRAB)<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Hipercalcemia (calcio s\u00e9rico &gt; 11,5 mg\/dl [2,88 mmol\/l])<\/li>\n<li>Insuficiencia renal (creatinina s\u00e9rica &gt; 2 mg\/dl [177 umol\/l])<\/li>\n<li>Anemia (hemoglobina &lt;10 g\/dl o &gt; 2 g\/dl por debajo del l\u00edmite inferior del rango normal)<\/li>\n<li>Enfermedad \u00f3sea (lesiones l\u00edticas, osteopenia grave, o fractura patol\u00f3gica)<\/li>\n<\/ul>\n<p style=\"font-weight: 400;\"><strong>Sistema internacional de estadificaci\u00f3n<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Etapa I: B2-microglobulina s\u00e9rica &lt;3,5 mg\/litro, alb\u00famina s\u00e9rica &gt;\/= 3,5 g\/dl<\/li>\n<li>Etapa II: B2-microglobulina s\u00e9rica &lt;3.5 mg\/litro m\u00e1s alb\u00famina s\u00e9rica &lt;3,5 g\/dl; o B2-microglobulina s\u00e9rica de 3,5 a &lt; 5,5 mg\/litro, independientemente del nivel de alb\u00famina s\u00e9rica<\/li>\n<li>Etapa III: B2-microglobulina s\u00e9rica &gt;\/= 5,5 mg\/litro<\/li>\n<\/ul>\n<p style=\"font-weight: 400;\"><strong>Anomal\u00edas cromos\u00f3micas<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Alto riesgo: presencia de t(14;4) o deleci\u00f3n 17p13 detectados por hibridaci\u00f3n in situ fluorescente<\/li>\n<li>Riesgo est\u00e1ndar: t(11;14) detectada por hibridaci\u00f3n in situ fluorescente<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p style=\"font-weight: 400;\"><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol style=\"font-weight: 400;\">\n<li>Durie BG, Harousseau JL, Miguel JS, Blad\u00e9 J, Barlogie B, Anderson K, Gertz M, Dimopoulos M, Westin J, Sonneveld P, Ludwig H, Gahrton G, Beksac M, Crowley J, Belch A, Boccadaro M, Cavo M, Turesson I, Joshua D, Vesole D, Kyle R, Alexanian R, Tricot G, Attal M, Merlini G, Powles R, Richardson P, Shimizu K, Tosi P, Morgan G, Rajkumar SV; International Myeloma Working Group. International uniform response criteria for multiple myeloma.\u00a0Leukemia. 2006 Sep;20(9):1467-73.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16855634\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Palumbo A, Anderson K. Multiple myeloma. N Engl J Med. 2011 Mar 17;364(11):1046-60.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21410373\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p style=\"font-weight: 400;\">Creado: Jun 17, 2007<\/p>\n<\/div>\n<p><\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Presencia de componente Ma\u00a0en suero y\/o en orina m\u00e1s c\u00e9lulas plasm\u00e1ticas monoclonales en m\u00e9dula \u00f3sea y\/o un plasmacitoma clonal documentado.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[171],"tags":[16,15,14,13,1381,755,469,754],"class_list":["post-2550","post","type-post","status-publish","format-standard","hentry","category-hematology","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-hematology","tag-mieloma","tag-multiple","tag-myeloma"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2550","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=2550"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2550\/revisions"}],"predecessor-version":[{"id":9121,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2550\/revisions\/9121"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2550"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2550"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}