A patient with a metastatic colon carcinoma was treated by immunoadsorption (IA) therapy using heat-killed, formalin-stabilized protein A-containing Staphylococcus aureus Cowan I as the immunoadsorbent. The patient experienced both subjective and objective positive clinical response without undue morbidity. The patient's response correlated well with laboratory findings of decreased concentrations of carcinoembryonic antigen (CEA), immunoglobulin G (IgG), immune complexes (IC) and histopathologic data. The patient underwent surgery following 15 IA treatments; she lived for eighteen months, post-treatment.
Patients with multiple myeloma who have complications secondary to hyperviscosity are treated by chemotherapy and/or plasmapheresis. Because the response to chemotherapy is usually delayed, plasmapheresis is required for the removal of larger concentrations of plasma proteins to avoid life-threatening complications. Until now there has been no available means to decrease the abnormal plasma proteins in a selective manner. This report describes a new method for the selective removal of immunoglobulin G from the plasma of a patient suffering from IgG-type multiple myeloma. Results obtained from plasmapheresis and selective immunoadsorption of IgG are compared. It appears that the technique described herein may offer a new, more efficient method for the palliative treatment of diseases associated with elevated concentrations of plasma immunoglobulin G.
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