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Plasma Exchange Role Uncertain in Multiple Myeloma

Numerous plasma exchanges do not substantially change outcome in patients with renal failure

THURSDAY, Dec. 8 (HealthDay News) -- Numerous plasma exchanges do not substantially change the outcome for patients with acute renal failure at the onset of multiple myeloma, according to a study published in the Dec. 6 issue of the Annals of Internal Medicine.

William F. Clark, M.D., of the University of Western Ontario, Canada, and colleagues studied 104 patients aged 18 to 81 with acute renal failure at the onset of myeloma in 14 Canadian medical centers from 1998 to 2004.

Participants were randomly assigned either conventional therapy, or conventional therapy plus five to seven plasma exchanges of 50 mL per kg of body weight of 5% human serum albumin for 10 days.

The primary composite end point occurred in 33 of 57 patients in the plasma exchange group, and 27 of the 39 control patients. One-third of patients in each group died.

"Despite 20 years of use and the formal endorsement of the Scientific Advisors of the International Myeloma Foundation, plasma exchange for managing acute renal failure in multiple myeloma can no longer be routinely recommended," stated the authors of an accompanying editorial.

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