【摘要】目的 探讨双重膜滤过式血浆置换(double filtration plasmapheresis，DFPP)治疗巨球蛋白血症的临床疗效。方法 回顾性分析在中国医科大学附属第一医院住院治疗的巨球蛋白血症患者16例，按照治疗方式的不同分为DFPP组（8例）与常规化疗组（8例），观察2组患者的近期疗效。结果 治疗3个月后，DFPP组比常规化疗组患者IgM显著下降（t=4.192,P＜0.01）。疗效评价：DFPP组8例中，7例DFPP同时联合化疗，2例完全缓解，5例部分缓解；1例因肝功能严重异常未联合化疗，未缓解；常规化疗组8例患者仅予MPT方案化疗，0例完全缓解，5例部分缓解，3例未缓解。结论 DFPP是治疗巨球蛋白血症的安全、有效、快捷的治疗方法之一。DFPP联合化疗可以迅速缓解巨球蛋白血症患者的临床症状，快速改善血生化指标，取得较好的近期疗效。
【Abstract】Objective To investigate the clinical effect of double-filtration plasmapheresis (DFPP) for Waldenstrom macroglobulinemia. Methods We retrospectively analyzed 16 cases with Waldenstrom macroglobulinemia treated in this hospital, and they were divided into DFPP group (8 cases) and routine chemotherapy group (8 cases). Their short-term therapeutic effect was analyzed. Results After 3 months of treatment, serum IgM was remarkably lower in DFPP group than in routine chemotherapy group (P<0.01). Of the 8 cases in DFPP group, 7 were given DFPP combined with chemotherapy, complete remission was found in 2 cases and partial remission in 5 cases; one case was treated with DFPP only without chemotherapy due to damaged liver function, and had no improvement. Of the 8 cases in routine chemotherapy group, partial remission was found in 5 cases, and no remission in 3 cases. Conclusion DFPP is a safe and effective in a short period of time method for the treatment of Waldenstrom macroglobulinemia. DFPP combined with chemotherapy can quickly alleviate the symptoms, improve the biochemical parameters, and achieve better therapeutic effect.
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