ObjectiveBased on the albumin substitution fluid, we performed plasma-free exchange in the removal of abnormal M protein for patients with multiple myeloma using Fresenius COM.TEC machine

MethodsFrom February 2016 to August 2018, 70 patients with multiple myeloma, who have indication of plasma exchange because of increased M protein, were treated with plasma-free exchange. Record the relevant basic information, the clinical symptoms and related disease indicators, and use SPSS 20.0 to analyze the changes of erythrocyte sedimentation rate, blood routine, albumin, renal function, serum calcium and immunoglobulin, and report adverse reactions.

ResultsAfter treatment, the patient's erythrocyte sedimentation rate, serum calcium, serum creatinine, β2-microglobulin, uric acid, IgG, IgA were significantly reduced; hemoglobin, white blood cell level were not statistically significant. The creatinine remission rate was 97%, and the platelet decline was only 17.8%, and no adverse reactions related to thrombocytopenia such as hemorrhage and ecchymoses were observed. Patients with IgG type responded better than IgA-free treatment to plasma-free exchange. There were no serious adverse reactions after treatment, 1 case of blood pressure drop, 2 cases of low calcium reaction, all in the normal range, and recovered after the end of treatment.

ConclusionPlasma-free exchange is an effective technology reducing M protein, which can effectively improve the erythrocyte sedimentation index, renal function index and blood viscous state. Patients with IgG type or higher ISS stage have more obvious effects. Plasma-free exchange significantly get rid of the application of fresh frozen plasma.


No relevant conflicts of interest to declare.

Author notes


Asterisk with author names denotes non-ASH members.