The Evolution in The Treatment of Multiple Myeloma Towards Targeted Magnetic Molecularly Imprinted

Multiple myeloma is the second more frequently haematological cancer in

the western world, after non-Hodgkin lymphoma, being about the 1-2 % of all

the cancers cases and the 10-13% of hematologic diseases. The disease is caused

by an uncontrolled clonal proliferation of plasma cells in the bone marrow that

accumulate in different parts of the body, usually in the bone marrow, around some

bones, and rarely in other tissues, forming tumor deposits, called

plasmocytomas

This uncontrolled clonal proliferation of plasma cells produces the secretion of an

abnormal monoclonal immunoglobulin (paraprotein or M-protein) and prevents

the formation of the other antibodies produced by the normal plasma cells that are

destroyed. The anormal secretion of paraproteins unbalance the osteoblastosis and

osteoclastosis processes, leading to bone lesions that cause lytic bone deposits and

the release of calcium from bones (hypercalcemia) that may produce renal failure.

Regions affected by bone lesions are the skull, spine, ribs, sternum, pelvis and bones

that form part of the shoulders and hips. The substitution of the healthy bone marrow

by infiltrating malignant cells and the inhibition of the normal production of red blood

cells produce anaemia, thrombocytopenia and leukopenia. Multiple myeloma patients

are immunosuppressed because of leukopenia and the abnormal immunoglobulin

production caused by the uncontrolled clonal proliferation of plasma cells, being

susceptible to bacterial infections, like pneumonias and urinary tract infections. The

interaction of immunoglobulin with hemostatic mechanisms may lead to haemorrhagic

diathesis or thrombosis. Also, disorders of the central and peripheral nervous system

are part of the disease, being the more common neurological manifestations the spinal

cord compressions and the peripheral neuropathies