Effect of plasmapheresis on systemic amyloidosis

Abstract

In order to clarify the effect of plasmapheresis on systemic amyloidosis, we performed plasma exchange (single-filtration plasmapheresis) on 2 patients with primary amyloidosis (AL type) and 1 patient with secondary amyloidosis due to rheumatoid arthritis (AA type). Fresh frozen plasma (3.2-4.5 liters each time) was used as replacement solution. Because amyloid deposition was already severe in all cases at the start of therapy, plasmapheresis did not extend the life of the patients. However, we found that plasma exchange delayed amyloid deposition in 1 patient with primary amyloidosis who was simultaneously receiving dimethyl sulfoxide treatment. We suggest, therefore, that plasma exchange therapy might extend the life of a patient if started at an earlier stage of systemic amyoidosis.