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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.

To identify this increasingly common pathology, known as multiple myeloma (MM), it is necessary to refer to the specific factors that characterize it; to this end, the classic criteria known as CRAB (hyperkalemia, renal failure, anemia, and lytic lesions) are available, in which renal failure is one of the most frequent complications. Recently, three indisputable biomarkers have been described for the diagnostic support for MM, which are: more than 10% of clonal plasma cells in bone marrow or, a biopsy that corroborates the presence of a plasmacytoma, light chain ratio ≥ 100 mg/dL and more than one focal lesion on magnetic resonance imaging. A differential diagnosis for plasma cell leukemia, solitary bone plasmacytoma, and extramedullary 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 afterward, 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.

Introduction: Multiple myeloma is multifocal neoplasia of plasmatic cells that affects the bone marrow. It is associated with the production of a urinary or serum protein. It represents approximately 1 percent of cancer cases worldwide and between 10 to 15 percent of all cases of hematological malignancy. Furthermore, it has been proposed that the β2-microglobulin levels are correlated with other factors that can predict multiple myelomas such as the number of plasmatic cells and the creatine levels. Goals: To determine the correlation between β2-microglobulin, globulin levels, and the number of plasmatic cells in patients with multiple myeloma. Methods and techniques: We conducted an observational, retrospective, transversal, and analytical study in the Hospital of the Mexican Institute of Social Security at the Veracruz port. Our population analyzed comprehended 45 patients between the ages 30 and 80 with a confirmed diagnosis of multiple myeloma. We measured the β2-microglobulin levels and globulin levels, and the number of plasmatic cells during the diagnosis of patients. Furthermore, we conducted a statistical analysis using a Pearson correlation. Results: The average age was 61 years with a margin of error of 11.48 years. The myeloma of IgG type was the one of major prevalence and represent 82.2 percent. It was followed by the IgA type and the IgM type, which represented 15.5 and 2.2 percent respectively. The Pearson correlation coefficient (Pearson's r) between the β2-microglobulin levels and globulin levels was 0.92. The Pearson's r between the number of plasmatic cells and β2-microglobulin, excluding patients with high serum creatine levels (i.e. larger than 1.2 mg/dl), was 0.371. Conclusions: The predominant type of myeloma in the analyzed population was the IgG type. Furthermore, this myeloma affected mainly men in our study. The average age was 61 years with a margin of error of 11.48 years when compared to other populations in our study.

To identify this increasingly common pathology, known as multiple myeloma (MM), it is necessary to refer to the specific factors that characterize it; to this end, the classic criteria known as CRAB (hyperkalemia, renal failure, anemia, and lytic lesions) are available, in which renal failure is one of the most frequent complications. Recently, three indisputable biomarkers have been described for the diagnostic support for MM, which are: more than 10% of clonal plasma cells in bone marrow or, a biopsy that corroborates the presence of a plasmacytoma, light chain ratio ≥ 100 mg/dL and more than one focal lesion on magnetic resonance imaging. A differential diagnosis for plasma cell leukemia, solitary bone plasmacytoma, and extramedullary 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 afterward, 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.Para identificar una patología cada vez más común, conocida como mieloma múltiple, es necesario hacer alusión de los factores específicos que la caracterizan. Para ello existen los clásicos criterios conocidos como CRAB (hipercalcemia, insuficiencia renal, anemia y lesiones líticas), siendo la insuficiencia renal una de sus complicaciones más frecuentes. Recientemente se han descrito tres biomarcadores indiscutibles para el apoyo diagnóstico del mieloma múltiple, que son: más del 10% de células plasmáticas clonales en medula ósea o biopsia que corrobora la presencia de un plasmocitoma, relación de cadenas ligeras ≥ 100 mg/dl y más de una lesión focal en resonancia magnética. Se debe tomar siempre en cuenta el diagnóstico diferencial con leucemia de células plasmáticas, plasmocitoma óseo solitario y plasmocitoma extramedular. Al ser una enfermedad incurable, se ha investigado mucho en cuanto al manejo terapéutico, el cual tiene como objetivo principal la desaparición de las células plasmáticas y la mejoría clínica del paciente. El primer fármaco que demostró algún beneficio fue el melfalán en el año 1958 y posteriormente al adicionar un esteroide como segundo fármaco se logró mejorar las tasas de respuesta. Después se fueron estudiando diferentes moléculas, con las que se han realizado múltiples combinaciones, alcanzando mejores tasas de supervivencia global y supervivencia libre de progresión. Años más tarde, con la llegada de los inhibidores de proteosoma como el bortezomib, así como de los agentes inmunomoduladores como la talidomida y la lenalidomida, se presenta un giro importante en la enfermedad, ya que se logran respuestas más profundas, periodo de remisiones más prolongadas y mejoría en la calidad de vida de los pacientes. Este consenso tiene la finalidad de integrar a un grupo de especialistas mexicanos y promover la actualización de esta patología.