Báo cáo trường hợp đa u tủy xương không tiết tại Viện Huyết học - Truyền máu Trung ương năm 2024=Case report of non-secretary multiple myeloma at National Institute of Hematology and Blood Transfusion in 2024

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Tác giả: Hữu Chiến Nguyễn, Thị Thanh Bình Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý:

Bộ sưu tập: Báo, Tạp chí

ID: 478246

Thêm vào giỏ

Đa u tủy xương không tiết (Non-secretory multiple myeloma-NSMM) là một bệnh lý ác tính về huyết học, định hướng đến chẩn đoán của bệnh hầu hết thông qua triệu chứng lâm sàng hoặc chẩn đoán hình ảnh về tổn thương xương. Đây là một dạng của bệnh Đa u tủy với sự tăng sinh của các tế bào plasmo, nhưng không thể tiết ra hoặc tổng hợp globulin miễn dịch. Tỷ lệ gặp thể bệnh này ở người lớn là tương đối thấp. Bài báo của chúng tôi mô tả một trường hợp Đa u tủy xương không tiết ở một phụ nữ 62 tuổi có biểu hiện lâm sàng duy nhất là đau xương cột sống thắt lưng, chẩn đoán hình ảnh có tổn thương tiêu xương rải rác (xương sọ, xương cột sống), không có sự xuất hiện của tổn thương ngoài tủy. Bệnh nhân được điều trị bằng phác đồ có sự kết hợp của thuốc nhắm đích, điều biến miễn dịch và có đáp ứng lâm sàng tốt. Chúng tôi xin trình bày báo cáo ca bệnh để chỉ ra sự khác biệt về đặc điểm lâm sàng, chẩn đoán và theo dõi điều trị ở bệnh nhân Đa u tủy xương không tiết so với Đa u tủy xương có tiết.Non-secretory multiple myeloma is a hematological malignancy, the diagnosis of which is mostly based on clinical symptoms or imaging of bone lesions. This is a form of multiple myeloma with proliferation of plasma cells, but cannot secrete or synthesize immunoglobulins. The incidence of this type of disease in adults is relatively low. Our article describes a case of non-secretory multiple myeloma in a 62-year-old woman whose only clinical manifestation was lumbar spine pain, with scattered osteolytic lesions (skull, spine) on imaging, without the appearance of extramedullary lesions. The patient was treated with a regimen that combined targeted drugs and immunomodulators and had a good clinical response. We present a case report to show the differences in clinical features, diagnosis and treatment monitoring in patients with nonsecretory multiple myeloma compared with secretory multiple myeloma.

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