Introdução: O mieloma múltiplo (MM) é uma gamopatia monoclonal incurável caracterizada pela proliferação maligna e clonal de plasmócitos na medula óssea, produzindo proteína M. A terapia do MM evoluiu na última década, com taxas de resposta geral > 90% e resposta completa > 50%. Entretanto, a recaída permanece alta, sugerindo que subclones resistentes persistem e que podem não ser medidos pelas técnicas atuais. Tradicionalmente, as taxas de resposta foram definidas pela urina e eletroforese de proteínas séricas, imunofixação e ausência de clones no exame histopatológico da medula óssea. Atualmente, existem vários ensaios sensíveis validados para estimar doença residual mínima (DRM). Objetivo: Descrever os novos métodos e técnicas utilizadas para detecção de DRM no MM. Material e métodos: Tratou-se de uma revisão narrativa, utilizando os descritores: Mieloma Múltiplo; Diagnóstico; Doença Residual Mínima. Foram realizadas buscas nas bases de dados Lilacs, Scielo e Pubmed, referentes ao período de 2015 a 2020. Foi incluído um total de 10 artigos neste estudo. Resultados: Os artigos analisados avaliaram os níveis de doença mínima verificáveis com sequenciamento e citometria de fluxo, ambos de última geração. A FDA aprovou esse teste de fluxo de 8 cores como o padrão para medir o grau de resposta em estudos clínicos de mieloma nos EUA. Além disso, o teste de isotipo de cadeia pesada + leve (Hevylite®), será incorporado aos critérios de resposta como marcador sanguíneo de baixo nível de atividade da doença. Em 2016, a Lancet Oncology publicou os critérios do International Myeloma Working Group para avaliação de resposta e doença residual mínima no MM com citometria de fluxo de última geração (NGF) e/ou sequenciamento de última geração (NGS). Conclusão: Novos métodos de detecção de DRM por NGF e NGS são técnicas promissoras para a avaliação da resposta ao tratamento do MM quando comparado às mais antigas.
Publicado
2021-02-01
Como Citar
Gregório, . M. I. F. D., Souza, L. M. A. de, & Moura, S. B. G. de. (2021). CENÁRIO ATUAL PARA DIAGNÓSTICO DE MIELOMA MÚLTIPLO RESIDUAL. Revista Multidisciplinar Em Saúde, 2(1), 33. https://doi.org/10.51161/rems/674
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