Plasmapheresis Therapy in Macroglobulinemia

Abstract

High viscosity or cold precipitability due to excessive amounts of serum gamma-macroglobulin may be responsible for many of the disease manifestations in macroglobulinemic patients. Plasmapheresis was used in ten such individuals to rapidly reduce serum macro-globulin levels and serum viscosity. Plasmapheresis was effective in improving macroglobulinemic retinopathy and visual disturbances, stopping hemorrhage, increasing red cell survival, improving auditory-vestibular disease and preventing seizures. Clinical and laboratory observations suggested that improvement was secondary to reduction of serum viscosity and macroglobulin level. Cold tolerance was improved in patients with eryomacroglobulinemia. Plasmapheresis was not effective in altering the thrombocytopenia or affecting the anemia in patients with aplastic or hypoplastlc bone marrows. Intermittent plasmapheresis proved to be an effective, safe form of therapy. Serum viscosity and macroglobulin could be maintained at reduced asymptomatic levels and, in some cases, allowed adequate time for trial of chemotherapy.