Myeloma treatment guidelines can be updated at SUS

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Posted on 08/06/2022 at 15:02

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In late May, the National Commission for the Integration of Technology into the Integrated Health System (Conitec) launched a public consultation on the update of the Guide to Multiple Myeloma Diagnostics and Therapeutics (DDT), the second most common type of blood cancer. munduan.munduan. Strangely enough, the World Health Organization (WHO) registered more than 176,000 new cases in 2020. In Brazil, between 2008 and 2017, 27,100 people diagnosed were treated in the Integrated Health System (SUS), according to the data. Oncology Observatory.

Myeloma affects the hematological system, which affects the cells responsible for producing antibodies, called plasma cells. When mutated, they become malignant and reproduce uncontrollably, creating accumulation in the bone marrow and endangering the production of other blood cells. Malignant plasma cells produce an abnormal protein called monoclonal protein.

Instead of functioning normally, plasma cells can cause serious damage to an individual’s health. With the progression of this disordered multiplication of abnormal cells, patients often feel discomfort as a warning sign. The first of these is back pain and, as it is generic, is sometimes unrelated to the pathology. In addition, other problems arise from cancer, which is why it is said to be “multiple”.

“The patient may start to have anemia as a result of this proliferation of bone marrow plasma cells. It can cause kidney failure in 30% to 40% of people. The diseased antibody filters the kidneys, causing an inflammatory process. As a result, it is common for many patients to have kidney failure and sometimes need dialysis, ”said Angelo Maiolino, Medical Coordinator of Hematology at the Americas Center for Integrated Oncology.

Angelo Maiolino, Medical Coordinator of Hematology at the American Center for Integrated Oncology.
Angelo Maiolino, Medical Coordinator of Hematology at the American Center for Integrated Oncology.
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In addition to damage to the kidneys, it is common for myeloma to appear frequently with bone lesions, resulting in constant fractures due to the weakening of the bone. Patients are also more susceptible to infectious processes because their immune system is not working properly.

With a high burden of symptoms, multiple myeloma puts the quality of life of patients at risk from the onset of the disease. With regard to the health of these people, a proposal to update DDT was presented in 2022. For Maiolino, this review is crucial, as the last one was only done in 2015.

“Over the last seven years, there has been very significant progress in the treatment of multiple myeloma, with regulatory approval of several new drugs. This requires an urgent update of this DDT.”
Angelo Maiolino

In practice, DDT is not an absolute rule to be used in SUS, however it is a guideline for treatment. Therefore, it is necessary to document the existing drugs and tests in Brazil, as well as new drug options. In this way, the patient has the opportunity to receive various care related to the disease.

As for the public consultation, Maiolino explained that the action is important because the medical community, patients and society as a whole can give their opinion on the issue. The doctor also stated that myeloma is one of the most common types of cancer in recent years in terms of new drugs.

“Although we understand that DDT is not a specific determination, it is a guideline. So it is important that this is included in this guide. Therefore, Conitec and the Ministry of Health are opening a public consultation. This is the moment. Then, when it is published, who knows when it will be new? It is a difficult, long process, but the renewal must be done less frequently in order to respond to the progress of the treatment, ”he said.

The public consultation is open until June 15, 2022 and can receive recommendations from any adult over the age of 18 through the website:
https://www.gov.br/participamaisbrasil/consulta-publica-conitec-sctie-n-34-2022-pcdt-mieloma-multiplo.

Other information about the disease

According to the International Myeloma Foundation (IMF), about 29% of patients needed more than a year to be diagnosed with multiple myeloma. 20% had an accurate diagnosis and 37% went through more than three doctors to finally be diagnosed. It is estimated that 7,600,000 new cases are identified in Brazil each year.

Although there is an incidence in the number of positive diagnoses, the cause of the hematological abnormality is unknown. Some cancers are directly related to external factors. Melanoma, for example, has a strong effect on sun exposure, as well as breast cancer (BRCA +) as a family component at risk. However, not all types of cancer have a well-established environmental or genetic relationship.

“Myeloma has no clear cause. It’s not genetic, but we know that families with this type of cancer are at higher risk. There are also conditions that promote this, such as exposure to certain chemical agents and radiation. Such theories, but there is no clear evidence.” explained Maiolino.

Article written by journalist Gabriella Collodetti

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