

Myeloma in real clinical practice
https://doi.org/10.33667/2078-5631-2024-29-64-67
Abstract
Multiple myeloma (MM) has a large number of nonspecific clinical manifestations, which also include manifestations from the bone system. MM is more common mainly in people over 50 years of age. In this age period, patients often seek medical help due to the development of degenerative-dystrophic changes in the musculoskeletal system (osteochondrosis), which can mask early clinical stigmata of MM. The prognosis for MM depends on the stage of the process at the time of diagnosis. Patients with stage I can live for many years without any treatment, while patients with stage III renal complications do not live long. Currently, advances in pharmacotherapy can improve patient survival. In this regard, the issue of early diagnosis of this condition comes to the fore. The proposed clinical observation considers the interpretation of individual clinical signs that allow MM to be suspected in patients with degenerative-dystrophic spinal disease. Thus, the clinical case we observed is interesting not only from the point of view of the importance of the clinical diagnosis, but also the timeliness of the start of treatment, which largely determines the prognosis of the disease.
About the Authors
N. Yu. TikhomirovaRussian Federation
Nadezhda Yu. Tikhomirova, PhD Med, associate professor
Dept of Faculty Therapy
Krasnodar
L. N. Eliseeva
Russian Federation
Lyudmila N. Eliseeva, DM Sci (habil.), professor, head of Dept
Dept of Faculty Therapy
Krasnodar
N. P. Belozerova
Russian Federation
Natalia P. Belozerova, PhD Med, assistant professor
Faculty Therapy
Krasnodar
E. S. Kameneva
Russian Federation
Elena S. Kameneva, PhD Med, assistant
Faculty of Advanced Education and Professional Retraining of Specialists; Dept of Polyclinic Therapy with a Course of General Medical Practice (family medicine)
Krasnodar
M. I. Bocharnikova
Russian Federation
Marina I. Bocharnikova, PhD Med, associate professor
Dept of Propaedeutics of Internal Disease
Krasnodar
References
1. Mendeleeva L. P., Votyakova O. M., Rekhtina I. G. Multiple myeloma/ Russian clinical guidelines for the diagnosis and treatment of malignant lymphoproliferative diseases; edited by I. V. Poddubnaya, V. G. Savchenko. Moscow, 2018. P. 213–241.
2. Furukawa Y., Kikuchi J. Molecular pathogenesis of multiple myeloma. Int. J. Clin. Oncol. 2015; 20 (3):413–422. DOI: 10.1007/s10147-015-0837-0
3. Lewis E. B. Leukemia, Multiple Myeloma, and Aplastic Anemia in American Radiologists. Science. 1963; 3598 (142): 1492–1494. DOI: 110.1126/science.142.3598.1492
4. Linet M. S., Harlow S. D., McLaughlin J.K. A case-control study of multiple myeloma in whites: chronic antigenic stimulation, occupation, and drug use. Cancer Res. 1987; 47 (11): 2978–2981. DOI: 110.1007/978-3-642-76655-8_16
5. Hallek M., Bergsagel P. L., Anderson K. C. Multiple myeloma: increasing evidence for a multistep transformation process. Blood. 1998; 91 (1): 3–21. DOI: 110.1182/blood.v91.1.3.3_3_21
6. Morgan G. J., Walker B. A., Davies F. E. The genetic architecture of multiple myeloma. Nat. Rev. Cancer. 2012; 12 (5): 335–348. DOI: 110.1172/jci61188
7. Fonseca R. et al. International Myeloma Working Group molecular classification of multiple myeloma: Spotlight review. Leukemia. Nature Publishing Group. 2009; 23 (12): 2210–2221. DOI: 110.1038/leu.2009.174
8. Malignant neoplasms in Russia in 2017 (morbidity and mortality). Edited by A. D. Kaprin, V. V. Starinsky, G. V. Petrova. M.: P. A. Herzen Moscow State Medical Research Institute – branch of the Federal State Budgetary Institution «NMIC of Radiology» of the Ministry of Health of the Russian Federation, 2018.
9. Hosing C. Hematopoietic stem cell mobilization with G-CSF.Methods Mol. Biol. HumanaPress Inc. 2012; 904: 37–47. DOI: 110.1007/978-1-61779-943-3_3
10. Sonneveld P. et al. Consolidation followed by maintenance vs. maintenance alone in newly diagnosed, transplant eligible multiple myeloma: a randomized phase 3 study of the European Myeloma Network. EHA 23 Proceedings. 2018; P. Abstract: S 108. DOI: 110.1182/blood.v128.22.242.242
11. Vladimirova L. Yu. et al. Practical recommendations for the prevention and treatment of nausea and vomiting in cancer patients. Practical recommendations of the Russian Society of Clinical Oncology. Drug treatment of malignant tumors. Supportive therapy in oncology. 2018. P. 502–511.
12. Bessmeltsev S. S. Multiple myeloma (Lecture). Bulletin of Hematology. 2014; 10 (3): 6–39. Edn Hjxarh.
13. Durie B. G.M., Salmon S. E. A clinical staging system for multiple myeloma correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer. 1975; 36 (3): 842–854. DOI: 110.1002/1097–0142(197509)36:3<842::aid-cn-cr2820360303>3.0.co;2-u
14. Greipp P. R. et al. International staging system for multiple myeloma. J. Clin. Oncol. 2005; 23 (15): 3412–3420. DOI: 110.1200/jco.2005.04.242
15. Palumbo A. et al. Revised international staging system for multiple myeloma: A report from international myeloma working group. J. Clin. Oncol. American Society of Clinical Oncology. 2015; 33 (26): 2863–2869. DOI: 110.1200/jco.2015.61.2267
16. Pop V. P., Rukavitsyn O. A. Multiple myeloma and related diseases. Moscow: GEOTAR-Media, 2016.
17. Shilova E. M., Smirnova A. V., Kozlovskaya N. L. Nephrology. Clinical recommendations. M.: GEOTAR-Media, 2016.
18. Kozlovskaya L. V., Rameev V. V., Kogarko I. N. [et al.] Kidney lesions associated with monoclonal gammapathy of uncertain significance: clinical forms, developmental mechanisms, treatment approaches. Clinical medicine. 2016; 94 (12): 892–901. DOI: 110.18821/0023-2149-2016-94-12-892-901
19. Hogan J. J., Alexander M. P., Leung N. Dysproteinemia and the kidney: Core Curriculum 2019. Am. J. Kidney Dis. 2019; 74 (6): 822–36. DOI: 110.1053/j.ajkd.2019.04.029
20. Kyle R. A. et al. Review of 1027 patients with newly diagnosed multiple myeloma Mayo ClinProc, 2003; 78 (1): 21–33. DOI: 110.4065/78.1.21
21. Smirnov A. V., Erdes Sh. F. Optimization of X-ray diagnostics of ankylosing spondylitis in clinical practice – the importance of a pelvic overview image. Scientific and practical rheumatology. 2015; 53 (2): 175–181. DOI: 110.14412/1995-4484-2015-175-181
Review
For citations:
Tikhomirova N.Yu., Eliseeva L.N., Belozerova N.P., Kameneva E.S., Bocharnikova M.I. Myeloma in real clinical practice. Medical alphabet. 2024;(29):64-67. (In Russ.) https://doi.org/10.33667/2078-5631-2024-29-64-67