RESUMEN
Se reporta el caso de una paciente con mieloma múltiple a quien se le hizo trasplante de células hematopoyéticas autólogas después de haber logrado la remisión con talidomida-dexametasona. Cuando ya no recibía tratamiento de mantenimiento postrasplante, la paciente tuvo una recaída del mieloma 28 meses después del trasplante. Después de conseguir la segunda remisión con talidomida-dexametasona, la paciente fue retrasplantada con el mismo esquema, pero sin tratamiento de mantenimiento postrasplante, con talidomida 100 mg al día. La paciente permanece en remisión completa estricta sostenida 55 meses después del segundo trasplante. La mayor parte de los estudios que analizan la utilidad de la talidomida como mantenimiento postrasplante suponen comparaciones entre pacientes que reciben o no la talidomida. Este caso muestra, en una misma paciente, que la talidomida indicada como mantenimiento postrasplante ha sido capaz de evitar una nueva recaída y prolongar la supervivencia libre de enfermedad. Palabras clave: myeloma múltiple, trasplante de células hematopoyéticas autólogas, talidomida-dexametasona.
Palabras clave:
The case of a patient with multiple myeloma is presented. She was autografted after achieving a complete remission and had a relapse while being followed without maintenance treatment 28 months after the graft. Once achieving a second remission she was re-autografted and subsequently given maintenance treatment with oral thalidomide, the patient remaining in a sustained stringent complete remission for a period of over 55 months. Information about the role of maintenance therapy in myeloma patients after achieving a remission stems mainly from trials comparing patients who have or not received thalidomide as maintenance therapy. Since the only difference between the two autografts was that in the second one maintenance with oral thalidomide was employed, this case clearly shows that it was the responsible for the long-lasting remission observed in the patient after the second autograft. Key words: Multiple myeloma, post-autograft, maintenance therapy.
Keywords: Multiple myeloma, post-autograft, maintenance therapy
ABSTRACT
The case of a patient with multiple myeloma is presented. She was autografted after achieving a complete remission and had a relapse while being followed without maintenance treatment 28 months after the graft. Once achieving a second remission she was re-autografted and subsequently given maintenance treatment with oral thalidomide, the patient remaining in a sustained stringent complete remission for a period of over 55 months. Information about the role of maintenance therapy in myeloma patients after achieving a remission stems mainly from trials comparing patients who have or not received thalidomide as maintenance therapy. Since the only difference between the two autografts was that in the second one maintenance with oral thalidomide was employed, this case clearly shows that it was the responsible for the long-lasting remission observed in the patient after the second autograft. Key words: Multiple myeloma, post-autograft, maintenance therapy.
Keywords: Multiple myeloma, post-autograft, maintenance therapy