Abstract
Multiple myeloma is a clonal proliferation of plasma cells in the bone marrow. It is characterized by its synthesis of a paraprotein detectable in serum and/or urine, on most occasions, along with evident organ damage or biomarkers of malignancy. Typical symptoms include bone pain as the main symptom, along with weakness and symptoms arising from hypercalcemia, renal insufficiency, and anemia. It is necessary to differentiate quiescent multiple myeloma, which does not lead to organ damage or have biomarkers of malignancy. In order to diagnose it, laboratory tests, a bone marrow study, and a radiological evaluation of the bone by means of computerized tomography scan or whole-body magnetic resonance imaging are necessary. Survival is around 7-8 years and has increased in recent years thanks to the emergence of new immunomodulatory treatments. In younger patients without organ dysfunction, standard treatment is induction therapy with a proteasome inhibitor (bortezomib), an immunomodulator (thalidomide or lenalidomide), and dexamethasone followed by an autologous hematopoietic progenitor cell transplantation with high doses of chemotherapy. Among patients who are not candidates for transplantation, various treatment schedules with very encouraging survival data are available, which will be adapted according to the patient's comorbidities.
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