Seder R H, Katz A E, Keggins J J, Blanchard G C, Oh S K, Berman L D, Vaughan C W, Hong W K, Strong M S
J Clin Apher. 1985;2(3):238-49. doi: 10.1002/jca.2920020307.
Six patients with advanced squamous cell cancers of the head and neck, with serum IgA greater than or equal to 400 mg/dl and IgE less than or equal to 1000 IU/ml, underwent a trial of six 2-liter plasma exchanges over a 2-3-week period. Disease progressed in patients 1, 2, and 4, who died on days 44, 72, and 159. The tumor in patients 3 and 6 regressed significantly, repeatedly in patient 3 over each of four courses of apheresis. Tumor recurred in both patients after cessation of treatment, and they died at days 420 and 79. Patient 5, with inoperable disease, received full-dose radiotherapy immediately following the course of apheresis, and showed complete response in the primary lesion and a major response in the extensive lymph node metastases, dying on day 421 of apparently unrelated causes. Serum IgE in the three patients experiencing tumor regression rose paradoxically during plasmapheresis. Only patient 3 had an elevated level of soluble E-receptor suppressor factor prepheresis; the serum of patient 6 was lymphocytotoxic prepheresis but this activity decreased or disappeared during each of the exchanges studied. Controlled trials are now indicated.
6例晚期头颈部鳞状细胞癌患者，血清IgA大于或等于400mg/dl且IgE小于或等于1000IU/ml，在2至3周内接受了6次每次2升的血浆置换试验。患者1、2和4病情进展，分别于第44、72和159天死亡。患者3和6的肿瘤明显消退，患者3在每次4个疗程的血液分离术中肿瘤均反复显著消退。治疗停止后，这两名患者肿瘤均复发，分别于第420天和第79天死亡。患者5患有无法手术的疾病，在血液分离术疗程后立即接受了全剂量放疗，原发灶显示完全缓解，广泛的淋巴结转移显示主要缓解，于第421天死于明显无关的原因。3例肿瘤消退患者的血清IgE在血浆置换期间反而升高。仅患者3在血液分离术前可溶性E受体抑制因子水平升高；患者6的血清在血液分离术前具有淋巴细胞毒性，但在每次研究的置换过程中这种活性降低或消失。现在需要进行对照试验。
