Abstract
In order to clarify the efficiency of combination treatment with dimethyl sulfoxide (DMSO) and plasma exchange, we compared the effects of combination treatment versus other conventional treatments in eleven patients with systemic amyloidosis. The combination treatment was carried out on one patient with primary amyloidosis and 3 with secondary amyloidosis. Plasma exchange was usually carried out by the single filtration method because it has been assumed that amyloid proteins show remarkable diversity in molecular size, and 5-10ml of DMSO was given percutaneously on the day before the plasma exchange therapy. Since amyloid deposition was already extensive in most cases at the start of therapy, among the 4 patients receiving the combination treatment 3 died within 1 year of admission. Mortality among the patients receiving other conventional treatments was also high, and the overall mortality of the 11 patients was 64 percent. Thus, it appeared that there were no differences in either survival or disease progression between these two groups. However, we found that the combination treatment delayed amyloid deposition and renal impairment in two patients.
We suggest, therefore, that the lifespan of a patient might be prolonged by this treatment which combines DMSO and plasma exchange, if initiated at an early stage of systemic amyloidosis.
