Cascade filtration for the control of hyperviscosity by the removal of IgM-paraprotein in Waldenstrom’s macroglobulinaemia

Cascade filtration (CF) is a double membrane filtering procedure, where the plasma, separated in the first step from blood, is simultanously pumped on a second membrane with lower cut-off, thus retaining the larger plasma molecules like IgM. The lower molecular plasma fractions containing the albumin, are reinfused to the patient. By this way the IgM level was reduced to 44% after each CF, while IgG was lowered only to 73% and albumin to 80% of its initial value. The plasma viscosity accordingly dropped from 1.77 to 1.27 m Pa·s. This special kind of plasmapheresis was done without any plasma protein substitution.