Hematological malignancies

A double-blind randomized cross-over study noted hematological improvement in patients with IgA and IgG monoclonal gammopathy, although clinically important outcomes were unaffected. Although there are no randomized trials to support its use in cryoglobulinemia and Waldenstrom's macroglobulinemia, plasmapheresis may provide valuable ancillary therapy to immunosuppression by rapidly depleting the offending cryoglobulins or macroglobulin, particularly in the setting of a crisis or hyperviscosity syndrome. Other hematological conditions in which plasmapheresis may be helpful include cold agglutinin autoimmune hemolytic anemia, acquired coagulant factor inhibitors, and coagulant factor deficiencies which require infusion of large volumes of fresh frozen plasma.

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