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espanolPara identificar una patologia cada vez mas comun, conocida como mieloma multiple, es necesario hacer alusion de los factores especificos que la caracterizan. Para ello existen los clasicos criterios conocidos como CRAB (hipercalcemia, insufi- ciencia renal, anemia y lesiones liticas), siendo la insuficiencia renal una de sus complicaciones mas frecuentes. Reciente- mente se han descrito tres biomarcadores indiscutibles para el apoyo diagnostico del mieloma multiple, que son: mas del 10% de celulas plasmaticas clonales en medula osea o biopsia que corrobora la presencia de un plasmocitoma, relacion de cade- nas ligeras ≥ 100 mg/dl y mas de una lesion focal en resonancia magnetica. Se debe tomar siempre en cuenta el diagnostico diferencial con leucemia de celulas plasmaticas, plasmocitoma oseo solitario y plasmocitoma extramedular. Al ser una enfer- medad incurable, se ha investigado mucho en cuanto al manejo terapeutico, el cual tiene como objetivo principal la desapa- ricion de las celulas plasmaticas y la mejoria clinica del paciente. El primer farmaco que demostro algun beneficio fue el melfalan en el ano 1958 y posteriormente al adicionar un esteroide como segundo farmaco se logro mejorar las tasas de respuesta. Despues se fueron estudiando diferentes moleculas, con las que se han realizado multiples combinaciones, alcan- zando mejores tasas de supervivencia global y supervivencia libre de progresion. Anos mas tarde, con la llegada de los inhi- bidores de proteosoma como el bortezomib, asi como de los agentes inmunomoduladores como la talidomida y la lenalido- mida, se presenta un giro importante en la enfermedad, ya que se logran respuestas mas profundas, periodo de remisiones mas prolongadas y mejoria en la calidad de vida de los pacientes. Este consenso tiene la finalidad de integrar a un grupo de especialistas mexicanos y promover la actualizacion de esta patologia. EnglishTo identify this increasingly common pathology, known as Multiple Myeloma, it is necessary to refer to the specific factors that characterize it; to this end, the classic criteria known as CRAB (hypercalcemia, renal failure, anemia and lytic lesions) are available, in which renal failure is one of the most frequent complications. Recently, 3 indisputable biomarkers have been described for the diagnostic support for Multiple Myeloma, which are: more than 10% of clonal plasma cells in BM or, a biop- sy that corroborates the presence of a plasmacytoma, light chain ratio ≥100 mg/dL and more than one focal lesion on mag- netic resonance imaging (MRI). A differential diagnosis for plasma cell leukemia, solitary bone plasmacytoma, and extramed- ullary plasmacytoma should always be considered. Being this an incurable disease, a lot of research has been done regarding its therapeutic management, whose main objective is the disappearance of plasma cells and the patient clinical improvement. Melphalan was the first drug that showed a benefit in 1958 and afterwards, with the addition of a steroid as a second drug, it was possible to improve response rates. Subsequently, different molecules were studied, forming multiple combinations, and achieving better rates of Overall Survival and Progression-Free Survival. Years later, with the arrival of proteasome inhibitors such as bortezomib, and immunomodulators such as thalidomide and lenalidomide, an important turnaround in the disease has been seen, as deeper responses, more prolonged remissions, and improvement in the quality of life of patients have been achieved. This consensus has the purpose of integrating a group of Mexican specialists and promoting the updating of this pathology.

Hodgkin's lymphoma is due to the clonal transformation of cells originating from B lymphocytes, generating the pathognomonic binucleate Reed-Sternberg cells. Hodgkin's lymphoma is a B cell disease with a bimodal distribution, with higher incidence in adolescence and the third decade of life, showing a second peak in people over 55 years of age. Classic Hodgkin lymphoma cells routinely undergo gene expression reprogramming, as they lose the expression of most of the typical B-cell genes and acquire the expression of multiple genes that are typical of other types of cells in the immune system. The treatment algorithm will depend on whether it is classic or predominantly lymphocytic HL, if it is early stage with unfavorable prognostic markers or not, the initial management regimen, and whether there is bulky disease, among the most relevant variables.

Hemophilia is a hemorrhagic disorder with a sex-linked inherited pattern, characterized by an inability to amplify coagulation due to a deficiency in coagulation factor VIII (hemophilia A or classic) or factor IX (hemophilia B). Sequencing of the genes involved in hemophilia has provided a description and record of the main mutations, as well as a correlation with the various degrees of severity. Hemorrhagic manifestations are related to levels of circulating factor, mainly affecting the musculoskeletal system and specifically the large joints (knees, ankles, and elbows). This document is a review and consensus of the main genetic aspects of hemophilia, from the inheritance pattern to the concept of women carriers, physiopathology and classification of the disorder, the basic and confirmation studies when hemophilia is suspected, the various treatment regimens based on infusion of the deficient coagulation factor as well as innovative factor-free therapies and recommendations for the management of complications associated with treatment (development of inhibitors and/or transfusion-transmitted infections), or secondary to articular hemorrhagic events (hemophilic arthropathy). Finally, relevant reviews of clinical and treatment aspects of hemorrhagic pathology characterized by acquired deficiency of FVIII secondary to neutralized antibodies named acquired hemophilia.

Background: There is no epidemiological registry in Mexico. The information about the epidemiology in our country is obtained by these types of studies, such as multicentric studies. A lot of improvements in the survival in non-Hodgkin lymphoma patients had occurred in the last 20 years. The access to treatment in these types of pathology could change the prognostic factors in Mexican Mestizos patients. The primary objective of the study was to learn what the most frequent histological varieties of non-Hodgkin lymphoma in Mexico are. The secondary objectives included clinical characteristics, treatments used, treatment response, disease-free survival and overall survival. Methods: A retrospective, descriptive study of consecutive cases was carried out in 14 hospitals across 14 Mexican states with patients diagnosed with non-Hodgkin lymphoma using the World Health Organization (WHO) 2008 criteria. Inclusion criteria included: ≥ 18 years of age, male or female, any clinical stage at diagnosis, who had received any chemotherapy regimen, with a known outcome. Descriptive statistics was performed for all variables, and survival was assessed using Kaplan-Meier curves. Results: Totally, 609 patients were enrolled, of which 545 were B-cell lymphomas and 64 were T-cell lymphomas. Median ages were 61 and 50, respectively. B-cell lymphomas were more common in males with 52.1%, and 65.5% of T-cell lymphomas occurred in females. For B-cell lymphomas, the two most frequent histological subtypes were diffuse large B-cell lymphoma in 63.9%, followed by follicular lymphoma at 18%. Meanwhile, 50% of T-cell lymphomas were of the T/natural killer (NK) subtype, and 87.1% of the patients received a CHOP-like regimen. Radiotherapy was given to 31% of B-cell Lymphomas and 46.9% of T-cell lymphomas. Overall survival at 9 years was 84.6% for B-cell lymphomas, and 73.4% for T-cell lymphomas. Conclusions: Diffuse large B-cell lymphoma constitutes the most frequent subtype for B-cell lymphomas in Mexico. The most frequent T-cell lymphoma is the NK/T histological subtype. World J Oncol. 2021;12(1):28-33 doi: https://doi.org/10.14740/wjon1351

PURPOSE The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. METHODS Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. RESULTS We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). CONCLUSION These results highlight the collateral damage of COVID-19 in oncology patients.

When diagnosed with ALL the age group between 18 and 45 years old (AYA, adolescents and young adults) do not have the good prognosis factors generally observed in children with this diagnosis. For a long time, it was undetermined whether they should be treated with continuous and sustained chemotherapy as children or whether receive sustained chemotherapy, but with longer rest periods like old adults. The medical care of adolescents and young adults with neoplastic diseases, grouped between 15 and 45 years of age, became an emerging research field of treatment in hematological diseases. Outcomes have asses complete response disease-free survival, and overall survival as markers of response, with very poor results reported. Relevant challenges have been identified in the AYA group with ALL that have drawn attention to the need to increase research in this area, particularly in the care of the population under 45 years of age with hematological malignancies.