Menu: Home :: go to Journal :: switch to Russian :: switch to English
You are here: all Journals and Issues→ Journal→ Issue→ Article

Selective elimination of immunoglobulin free light chains in patients with monoclonal gammapathies


The first experience of free light chains of immunoglobulin (FLC) elimination in Russia with selective filters Emic2 in patients with paraproteinemic haemoblastosis and significant FLC hypersecretion are represented in this article. According to the results of FLC secretion measuring in blood serum and dialyzate before and after treatment in 12 patients, we demonstrate the possibility of extracorporal elimination from 250 to 196000 mg of FLC in one procedure. Maximal quantity of FLC, which was eliminated during the whole course of treatment (18 procedures), was 1090 g. We demonstrate the high efficiency of extracorporal detoxication by removal of FLC excess from bloodstream, which prevents the development of irreversible renal failure and give the possibility to perform an adequate chemotherapy.


free light chains of immunoglobulin; monoclonal gammapathies; multiple myeloma; lymphoma; extracorporal haemocorrection; selective filters

Full-text in one file









1. Knudsen L.M., Hjorth M., Hippe E. Renal failure in multiple myeloma: Reversibility and impact on prognosis. Eur. J. Haematol., 2000, vol. 65 (3), pp. 175-181. 2. Kyle R.A., Gertz M.A., Witzig T.E., Lust J.A., Lacy M.Q., Dispenzieri A., Fonseca R., Rajkumar S.V., Offord J.R., Larson D.R., Plevak M.E. Therneau T.M., Greipp P.R. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin. Proc., 2003, vol. 78 (1), pp. 21-33. 3. Sakhuja V., Jha V., Varma S., Joshi K., Gupta K.L., Sud K., Kohli H.S. Renal involvement in multiple myeloma: a 10-year study. Ren. Fail., 2000, vol. 22 (4), pp. 465-477. 4. Lyubimova N.V., Turko T.A., Votyakova O.M., Kushlinskiy N.E. Svobodnye legkie tsepi immunoglobulinov v syvorotke krovi bol'nykh monoklonal'nymi gammapatiyami [Free light chains of immunoglobulin in blood serum at patients with monoclonal gammapathies]. Byulleten' eksperimental'noy biologii i meditsiny [The Bulletin of Experimental Biology and Medicine], 2012, no. 153 (2), pp. 217-222. (In Russian). 5. Lyubimova N.V., Kharitidi T.Yu., Danilov A.N., Votyakova O.M. Svobodnye legkie tsepi immunoglobulinov – biokhimicheskie markery monoklonal'nykh gammapatiy [Free light chains of immunoglobulin – biochemical markers of monoclonal gammapathies]. Molekulyarnaya meditsina – Molecular Medicine, 2013, no. 1, pp. 56-60. (In Russian). 6. Hutchison C.A., Cockwell P., Reid S., Chandler K., Mead G.P., Harrison J., Hattersley J., Evans N.D., Chappell M.J., Cook M., Goehl H., Storr M., Bradwell A.R. Efficient removal of immunoglobuline free light chains by hemodialysis for multiple myeloma: In-vitro and in-vivo studies. J. Am. Soc. Nephrol., 2007, vol. 18 (3), pp. 886-895. 7. Iggo N., Winearls C.G., Davies D.R. The development of cast-nephropathy in multiple myeloma. QJM, 1997, vol. 90 (11), pp. 653-656. 8. Leung N., Gertz M.A., Zeldenrust S.R., Rajkumar S.V., Dispenzieri A., Fervenza F.C., Kumar S., Lacy M.Q., Lust J.A., Greipp P.R., Witzig T.E., Hayman S.R., Russell S.J., Kyle R.A., Winters J.L. Improvement of cast nephropathy with plasma exchange depends on the diagnosis and on reduction of serum free light chains. Kidney Int., 2008, vol. 73 (11), pp. 1282-1288. 9. Zucchelli P., Pasquali S., Cagnoli L., Ferrari G. Controlled plasma exchange trial in acute renal failure due to multiple myeloma. Kidney Int., 1988, vol. 33 (6), pp. 1175-1180. 10. Clark W.F., Stewart A.K., Rock G.A., Sternbach M., Sutton D.M., Barrett B.J., Heidenheim A.P., Garg A.X., Churchill D.N. Canadian Apheresis Group. Plasma exchange when myeloma presents as acute renal failure: a randomized controlled trial. Ann. Intern. Med., 2005, vol. 143 (11), pp. 777-784. 11. Curti A., Schwarz A., Trachsler J., Tomonaga Y., Ambühl P.M. Therapeutic efficacy and cost effectiveness of high cut-off dialyzers compare to conventional dialysis in patients with cast nephropathy. PLos One, 2016, vol. 11 (7), p. e0159942. 12. Rajkumar S.V., Dimopoulos M.A., Palumbo A., Blade J., Merlini G., Mateos M.V., Kumar S., Hillengass J., Kastritis E., Richardson P., Landgren O., Paiva B., Dispenzieri A., Weiss B., LeLeu X., Zweegman S., Lonial S., Rosinol L., Zamagni E., Jagannath S., Sezer O., Kristinsson S.Y., Caers J., Usmani S.Z., Lahuerta J.J., Johnsen H.E., Beksac M., Cavo M., Goldschmidt H., Terpos E., Kyle R.A., Anderson K.C., Durie B.G., Miguel J.F. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol., 2014, vol. 15 (12), pp. 538-548.



Section of issue


Для корректной работы сайта используйте один из современных браузеров. Например, Firefox 55, Chrome 60 или более новые.