Hu Yuru, Yang Hanshan, Fu Shaozhi, Wu Jingbo
Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China.
Cancer Manag Res. 2022 Feb 2;14:411-425. doi: 10.2147/CMAR.S340472. eCollection 2022.
Therapeutic plasma exchange is used as a trial method for the treatment of cancer patients. Therapeutic plasma exchange uses in vitro technology to remove pathogenic factors in the plasma, returning the replacement and remaining components to the patient to facilitate cure. In the effort to explore new methods of cancer treatment, the introduction of therapeutic plasma exchange brings new hope for cancer treatment; however, the current evidence supporting therapeutic plasma exchange is controversial, and most of the evidence comes from observational studies, lacking large prospective randomized trials. Therefore, this review attempts to focus on the main indications of therapeutic plasma exchange for the treatment of tumors and their complications, including hematological tumors (multiple myeloma cast nephropathy and hyperviscosity syndrome), nervous system tumors (myasthenia gravis associated with thymoma, paraneoplastic neurological syndrome, Lambert-Eaton myasthenia syndrome, and anti-N-methyl-D-aspartate receptor encephalitis), overdose of chemotherapy drugs. In addition, the issues of side-effects and safety in the use of therapeutic plasma exchange are also discussed. However, well-designed prospective trials are needed to better define the role of therapeutic plasma exchange in cancer.
治疗性血浆置换被用作治疗癌症患者的一种试验方法。治疗性血浆置换利用体外技术去除血浆中的致病因素，将置换后的成分和剩余成分回输给患者以促进治愈。在探索癌症治疗新方法的过程中，治疗性血浆置换的引入为癌症治疗带来了新希望；然而，目前支持治疗性血浆置换的证据存在争议，且大部分证据来自观察性研究，缺乏大型前瞻性随机试验。因此，本综述试图聚焦于治疗性血浆置换治疗肿瘤及其并发症的主要适应证，包括血液系统肿瘤（多发性骨髓瘤管型肾病和高黏滞综合征）、神经系统肿瘤（胸腺瘤相关重症肌无力、副肿瘤性神经综合征、兰伯特-伊顿肌无力综合征和抗N-甲基-D-天冬氨酸受体脑炎）、化疗药物过量。此外，还讨论了治疗性血浆置换使用中的副作用和安全性问题。然而，需要设计良好的前瞻性试验来更好地界定治疗性血浆置换在癌症治疗中的作用。
