Plasma exchange followed by chemotherapy treatment for multiple-myeloma patients with high viscosity syndrome and renal dysfunction: a clinical analysis
10.13303/j.cjbt.issn.1004-549x.2017.07.019
- VernacularTitle:多发性骨髓瘤伴高黏滞综合征和肾功能损害患者行血浆置换术序贯化疗临床观察
- Author:
Fei GAO
;
Jia WANG
;
Tao OU
;
Wanchun XIE
- Keywords:
plasma exchange;
chemotherapy;
multiple myeloma;
high viscosity syndrome;
renal dysfunction
- From:
Chinese Journal of Blood Transfusion
2017;30(7):708-710
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the clinical performance of plasma exchange (PE) followed by chemotherapy treatment for multiple-myeloma patients with high-viscosity syndrome and renal dysfunction.Methods 20 cases of multiple-myeloma patients with high viscous syndrome and various levels of renal dysfunction,were randomly divided into PE-chemotherapy group (the experiment groups) and chemotherapy-only group (the control group).In the experiment groups,the patients received PE via blood cell separators for 3 times (2 600±580 mLeach time,1 day interval) followed by VAD regimens chemotherapy (0.5 mg vincristine continuous intravenous drip for 12 h,adriamycin 10 mg continuous intravenous drip for 12 h and dexamethasone 40 mg qd1-4).In the control group,patients received standard VAD regimen.After 2 cycles of chemotherapy,globulin (GLB),blood sedimentation (ESR) and hemorheology properties were compared between the two groups before and after treatment.Results The symptoms of high viscosity syndrome(gingivial blood/nosebleed,dizziness and extremities numbness)in the treatment group were significantly improved compared with that in the control group (P＜ 0.05).Before and after therapy,the GLB (g/L) were 80.0± 19.6 vs 30.0±10.5 in the treatment group and 85.5±21.5 vs 53.5± 16.0 in the control group (P＜0.05),respectively;the Cr (μmol/L) were 359.0±30.5 vs 105.0±25.0 and 362.0±39.6 vs 190.0±43.0,respectively(P＜0.05);the ESR (mm/h) were 80.0±22.5 vs 12±0.6 and 83.0±23.6 vs 30.0+3.6 (P＜0.05),respectively;the whole blood high shear reductive viscosity were 16.2±2.1 vs 8.5±0.6 and 15.8±2.0 vs 12.8±0.8 (P＜0.05),respectively;the whole blood middle shear reductive viscosity were 19.0±0.5 vs 10.8±0.6 and 20.0±0.6 vs 15.2±0.8 (P＜0.05),respectively;the whole blood low shear reductive viscosity were 50.3±2.9 vs 28.1±1.2 and 52.7±3.5 vs 40.2±3.5(P＜0.05),respectively.Conclusion Plasma exchange treatment combined with sequential chemotherapy presents better clinical performances compared to the chemotherapy-only solution for multiple-myeloma patients with high viscosity syndrome and renal dysfunction.
