Causas de muerte en el mieloma múltiple. Causes of death in multiple myeloma

Se revisaran los protocolos de necropsias y las historias clinicas de 30 pacientes fallecidos por mieloma multiple en el hospital general "Abel Santamaria Cuadrado", para evaluar las caracteristicas clinicas y anatomopatologicas de estos pacientes. Predomino el sexo masculino 19 casos (63.3%), la edad promedio fue de 62.3 anos. Los estadios clinicos mas frecuentes fueron el IIIB con 13 casos (43.4%) y el IIIA 10 (33.4) representado ambos el 76.8% de la muestra. Las manifestaciones clinicas mas frecuentes al diagnostico de la enfermedad fueron anemia y dolores oseos. La sobrevida media global fue de 2 anos. Las enfermedades asociadas mas frecuentes fueron la arteriosclerosis (50%) y el enfisema pulmonar (43.3%). Las alteraciones renales halladas en las necropsias fueron: nefropatia tubular del mieloma (13.3%), la nefritis cronica intersticial y necrosis del epitelio tubular renal (10%). Las causas directas de muertes fueron bronconeumonia en un 50%, Insuficiencia renal 13.4%, mieloma multiple diseminado 13.4 % . DeCS: BRONCONEUMONIA, INSUFICIENCIA RENAL CRONICA, MIELOMA MULTIPLE/mortalidad. ABSTRACT The protocols of necrotomies and clinical records of 30 patients whose mortality cause was multiple myeloma were received at Abel Santamaria General Hospital aimed at assessing clinical and anatomopathological characteristics of these patients. Masculine sex prevailed 19 cases (63.3 %), the average age was 62.3 years. The most frequent clinical stages were IIIB presenting 13 cases (43.4 %) and IIIA with 10 cases (33.4 %) both represented the 76.8 % of the sample. The most frequent clinical manifestations in the diagnosis of the disease were anaemia and skeletal pain. Global mean survival was of 2 years, the associated diseases were arteriosclerosis (50 %) and pulmonary emphysema (43.3 %). Renal disorders found in the necrotomies were tubular nephropathy of myeloma (13,3 %), chronic interstitial nephritis and renal tubular necrosis of the epithelium (10 %). Mortality direct causes were bronchopneumonia (50 %), renal failure (13.4 %) and disseminated multiple myeloma (13.4 %). DeCS: BRONCHOPNEUMONIA, KIDNEY FAILURE, ACUTE, MULTIPLE MYELOMA/mortality.