Macro and microrheological variations observed during plasma exchange in cases of monoclonal disglobulinemia

Massive plasma exchange (more than 3 litres) can be achieved during various hyperviscosity syndromes using cell separators.

The authors report on a rheological survey undertaken on 30 patients with Kahler’s disease, 7 cases of Waldenström’s disease, 2 cases of CLL with monoclonal gammapathy, 3 cases of non Ibdgkinian malignant lymphoma and 2 cases of isolated cryoglobulinemia. The rheological parameters studied covered plasma and blood viscosity, red blood cell aggregability (nephelometry and study with a rheoscope).

The results revealed a systematic decrease in plasma and blood viscosity following exchange procedures, with a slow recovery after the exchange. A decrease in aggregability is observed when exchange procedures are carried out using diluted albumin (4%).

In conclusion, systematic assessment of the rheological parameters can be considered as a good test for following up plasma exchange procedures during diseases accompanied by a hyperviscosity syndrome.