Treatment of Hyperviscosity Syndrome with an Indication for Therapy and No Symptoms
Clinical scenario
Patients presenting with hyperviscosity who carry a clear indication for treatment but remain asymptomatic. In this setting, the goal is to act before symptoms develop rather than manage an acute viscosity crisis.
Approach
Rapid-acting systemic chemotherapy can reduce serum viscosity by lowering protein levels — and in doing so, may obviate the need for plasma exchange. The specific agents and sequencing appropriate to the individual patient are detailed in the full protocol.
Treatment goal
The primary target is reduction of the serum IgM level. An IgM reduction of as little as 25% is clinically meaningful and can completely eliminate hyperviscosity symptoms.
References
DOI: 10.1182/blood-2018-06-846816
- For patients who have hyperviscosity, an indication for therapy, and no symptoms, rapid-acting systemic chemotherapy can reduce the serum viscosity and obviate the need for plasma exchange.
- In most instances, an IgM reduction of as little as 25% will completely eliminate symptoms of hyperviscosity.