Two patients of cryoglobulinemia associated with multiple myeloma were treated very effectively by plasma exchange using an IBM Model 2997 Blood Cell Separator.
We used, as a replacement fluid in a subsequent plasma exchange, cryoglobulin-depleted autologous plasma by removing abnormal proteins after cold incubation. The patient's plasma was collected into 300-500ml transfer packs and replaced by equivalent volume of fresh frozen plasma at first. They were stored at 4°C or at -2°C during 14-21 days. Then the plasma was centrifuged at 4°C, 1600xG for 30 minutes. The supernatant in which cryoglobulin was removed could be used as a replacement fluid in the next plasma exchange.
It is concluded that the advantages of autologous plasma exchange seem to be substantial: all risks of incompatibility or of alloimmunization, and of transmission of infectious diseases such as viral hepatitis, are completely avoided. In addition, the expensive cost of the replacement fluid can be saved markedly.
