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Métodos laboratoriais para o diagnóstico de mieloma múltiplo
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O mieloma múltiplo (MM) é uma neoplasia maligna das células plasmáticas, caracterizada pela proliferação clonal de células plasmática na medula óssea, que compromete a hematopoiese normal. A incidência é superior em indivíduos afro-americanos e do sexo masculino. O diagnóstico baseia-se numa avaliação clínica e laboratorial e requer a presença de, pelo menos, um evento definidor de mieloma (CRAB: hipercalcemia, insuficiência renal, anemia e lesões ósseas) associado a plasmocitose medular clonal superior a ³10%. Objetivo: analisar e sistematizar, através de revisão bibliográficaos principais métodos laboratoriais utilizados no diagnóstico do MM, destacando a sua eficácia, precisão e aplicabilidade na prática clínica. Metodologia: Foi realizada uma revisão bibliográfica com recurso a base de dados científicas (Pubmed, Medline, Cochrane Library).
Foram selecionadas 79 referências científicas publicadas entre 2002 e 2025 sobre Mieloma múltiplo. Conclusão: O diagnóstico do MM requer uma abordagem multidisciplinar, integrando dados laboratoriais, clínicos e imagiológicos, essenciais para a definição do estadiamento, prognóstico e planeamento terapêutico. A vigilância regular é fundamental para detetar precocemente a progressão de gamopatias monoclonais de significância indeterminada (MGUS) para MM.
Multiple myeloma (MM) is a malignant neoplasm of plasma cells, characterized by the clonal proliferation of plasma cells in the bone marrow, leading to impairment of normal hematopoiesis. Its incidence is higher among African American individuals and males. Diagnosis is based on clinical and laboratory evaluation and requires the presence of at least one myeloma-defining event (CRAB: hypercalcemia, renal insufficiency, anemia, and bone lesions) associated with clonal bone marrow plasmacytosis ≥10%. Objective: To analyze and systematize, through a literature review, the main laboratory methods used in the diagnosis of MM, highlighting their effectiveness, accuracy, and applicability in clinical practice. Methodology: A literature review was conducted using scientific databases (PubMed, Medline, and the Cochrane Library). A total of 79 scientific references published between 2002 and 2025 on multiple myeloma were selected. Conclusion: The diagnosis of MM requires a multidisciplinary approach, integrating laboratory, clinical, and imaging data, which are essential for disease staging, prognostic assessment, and therapeutic planning. Regular monitoring is crucial for the early detection of progression from monoclonal gammopathy of undetermined significance (MGUS) to MM.
Multiple myeloma (MM) is a malignant neoplasm of plasma cells, characterized by the clonal proliferation of plasma cells in the bone marrow, leading to impairment of normal hematopoiesis. Its incidence is higher among African American individuals and males. Diagnosis is based on clinical and laboratory evaluation and requires the presence of at least one myeloma-defining event (CRAB: hypercalcemia, renal insufficiency, anemia, and bone lesions) associated with clonal bone marrow plasmacytosis ≥10%. Objective: To analyze and systematize, through a literature review, the main laboratory methods used in the diagnosis of MM, highlighting their effectiveness, accuracy, and applicability in clinical practice. Methodology: A literature review was conducted using scientific databases (PubMed, Medline, and the Cochrane Library). A total of 79 scientific references published between 2002 and 2025 on multiple myeloma were selected. Conclusion: The diagnosis of MM requires a multidisciplinary approach, integrating laboratory, clinical, and imaging data, which are essential for disease staging, prognostic assessment, and therapeutic planning. Regular monitoring is crucial for the early detection of progression from monoclonal gammopathy of undetermined significance (MGUS) to MM.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Métodos laboratoriais Diagnóstico Mieloma múltiplo