Follow-up of certain immunologic indicators in the treatment of plasmacytoma with cyclophosphamide in combination with plasmapheresis.

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.