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Introduction Monoclonal immunoglobulins or immunoglobulin fragments that accumulate in the plasma are referred to as M-proteins. When the plasma concentration of an M-protein is low (generally < 3.0 gm/dL) and does not rise over time the M-protein is referred to as a monoclonal gammopathy of uncertain significance and the prognosis is generally benign. However in certain M-protein disorders, notably multiple myeloma and Waldenström’s macroglobulinemia, the plasma M-protein concentration usually increases and this may result in clinical disease. The complications of M-protein disorders that relate most directly to therapeutic apheresis are hyperviscosity syndrome and myeloma kidney. Both of these are direct clinical complications of the M-protein in patients with Waldenström’s macroglobulinemia or multiple myeloma, thus both are considered to be category II indications for plasma exchange by the American Society for Apheresis. The designation category II means that therapeutic apheresis is accepted as a supportive or adjunctive treatment but is not ordinarily the only treatment that should be used. Thus, chemotherapy would also be required to achieve longterm control of these disorders while plasma exchange is used for short-term control or relief of symptoms.

Palabras clave: Therapeutic apheresis plasma exchange myeloma treatment hyperviscosity.

2012-07-30   |   477 visitas   |   Evalua este artículo 0 valoraciones

Vol. 43 Núm.6. Diciembre 2005 Pags. 159-161 Rev Med Inst Mex Seguro Soc 2005; 43(Supl. 1)