[Multiple plasma exchanges in patients with advanced malignant disease]

Multiple plasma exchange represents an empirical attempt to clear "immunosuppressive factors" from the plasma of cancer patients. Plasma exchanges have been performed in 32 patients with advanced malignant disease. Up to 4000 ml of plasma have been replaced by one single plasma exchange. Serum proteins including acute phase reactants were monitored before and after plasma exchange. A transient change of these proteins was observed on the first day, but later on, pretreatment values were always regained. Skin reactions to recall and new antigens were enhanced in many patients after plasma exchanges. Peripheral blood lymphocyte blastogenic response to mitogen was slightly increased in patients after plasma exchanges. Plasma exchange was found to decrease significantly the inhibitory effect of patients' sera on normal donor lymphocyte reactivity. Therefore, multiple plasma exchanges could have a practical role to play in immunotherapy.