Sakalová A, Gazová S, Hrubisko M, Pokorná G, Mayer J
Neoplasma. 1975;22(1):63-7.
Changes in the immunoglobulin and complement levels in untreated plasmacytoma were compared with those resulting from massive doses of Cyclophosphamide (15--25 mg per kg b. w. at intervals of 10--14 days) applied in combination with double plasmapheresis (involving removal of about 500 ml of plasma). A follow-up of the levels of normal immunoglobulins, paraprotein, total complement and the C3 component revealed a significant decline in the total complement following each single application of this treatment, but the decrease in C3 was nonsignificant. A decline of about 20% in immunoglobulins and of about 15% in paraprotein was observed in relation to the pretreatment values, but only that in the IgM class proved to be of statistical significance. The decrease in proteins was also established with the methods of total protein determination (refractometric or biuret methods) and was found to amount to 1000--3000 mg% after each dose of Cyclophosphamide with plasmapheresis. In the author's view, a combined Cyclophosphamide-plasmapheresis treatment is effective for achieving clinical remission. It should, however, be kept in mind that the effect of protein and paraprotein depression persists for only a few days, hence, to achieve long-term results, this treatment should be repeated in 2--3 week's cycles. The lowered values of humoral immunity indicators do not increase the danger of complications from a clinical aspect, when suitable preventive measures are taken.
将未经治疗的浆细胞瘤患者的免疫球蛋白和补体水平，与大剂量环磷酰胺（每千克体重15 - 25毫克，每隔10 - 14天给药一次）联合双重血浆置换（每次去除约500毫升血浆）后的水平进行比较。对正常免疫球蛋白、副蛋白、总补体和C3成分水平的随访显示，每次进行这种治疗后，总补体水平均显著下降，但C3的下降不显著。与治疗前的值相比，免疫球蛋白下降约20%，副蛋白下降约15%，但只有IgM类的下降具有统计学意义。通过总蛋白测定方法（折射法或双缩脲法）也证实了蛋白质的减少，发现每次环磷酰胺联合血浆置换给药后，蛋白质减少量为1000 - 3000毫克%。作者认为，环磷酰胺联合血浆置换治疗对于实现临床缓解是有效的。然而，应该记住的是，蛋白质和副蛋白降低的效果仅持续几天，因此，为了获得长期效果，这种治疗应以2 - 3周的周期重复进行。当采取适当的预防措施时，体液免疫指标的降低值从临床角度来看不会增加并发症的风险。
