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Waldenstrom macroglobulinaemia treated with sequential hemibody irradiation
Author(s) -
Jacobs Peter,
Wood Lucille,
Roux Ingrid Le,
Prior Clive,
King Helen S.
Publication year - 1987
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.2920030312
Subject(s) - plasmapheresis , medicine , bone marrow , multiple myeloma , waldenstrom macroglobulinemia , chemotherapy , macroglobulinemia , haematopoiesis , intensive care medicine , surgery , immunology , gastroenterology , lymphoma , antibody , stem cell , biology , genetics
A 40‐year‐old man presented with symptoms of anaemia and blurred vision. Waldenstrom macroglobulinaemia was diagnosed on the basis of plasmacytoid lymphocytes in the peripheral blood, extensive bone marrow involvement, and an IgM kappa monoclone in the plasma of 48 g/liter. Symptoms were immediately reversed by isovolaemic continuous‐flow plasmapheresis coupled with red cell transfusion. Specific therapy was undertaken with sequential hemibody irradiation. At two years of follow‐up the patient enjoys excellent health, has improved haematopoietic reserve in the bone marrow, and the only therapy required is intermittent plasmapheresis to control symptoms relating to rising viscosity. Thus, systemic irradiation, which is well tolerated and objectively reduces marrow tumour bulk, offers an alternative to chemotherapy in the palliative management of active macroglobulinaemia and may diminish but not prevent the need for intermittent plasmapheresis.